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The Life and Health Insurance Protection
Association Act
10-20-101 - Short title
10-20-102
- Legislative declaration
10-20-103
- Definitions
10-20-104
- Coverage and limitations - coordination of benefits
10-20-105
- Construction
10-20-106
- Creation of the association
10-20-107
- Board of directors
10-20-108
- Powers and duties of the association
10-20-109
- Assessments
10-20-110
- Plan of operation
10-20-111
- Powers and duties of the commissioner
10-20-112
- Prevention of insolvencies
10-20-113
- Credits for assessments paid - tax offsets
10-20-114
- Miscellaneous provisions
10-20-115
- Examination of the association - annual report
10-20-116
- Tax exemptions
10-20-117
- Immunity
10-20-118
- Stay of proceedings - reopening default judgments
10-20-119
- Prohibited advertisement of association article in insurance sales -
notice to policyholders
10-20-120
- Prospective application
10-20-101
- Short title.
This article shall be known and may be cited as the
"Life and Health Insurance Protection Association Act".
Source:
L. 91: Entire article added, p. 1256, § 1, effective July 1.
10-20-102
- Legislative declaration.
(1) The general assembly finds and declares that the
purpose of this article is to protect, subject to certain limitations, the
persons specified in section 10-20-104 (1) against failure by member
insurers in the performance of their contractual obligations under life
and health insurance policies and annuity contracts specified in section
10-20-104 (2), because of the insolvency of the member insurer that issued
the policies or contracts.
(2)
To provide the protection specified in subsection (1) of this section, an
association of insurers shall be created and shall exist to pay benefits
and to continue coverages as limited pursuant to this article. Members of
the association are subject to assessment to provide funds to carry out
the purpose of this article.
Source:
L. 91: Entire article added, p. 1256, § 1, effective July 1.
10-20-103
- Definitions.
As used in this article, unless the context otherwise
requires:
(1)
"Account" means any of the three accounts created pursuant to
section 10-20-106.
(2)
"Association" means the life and health insurance protection
association as established by this article.
(3)
"Board" means the board of the association.
(4)
"Commissioner" means the commissioner of insurance.
(5)
"Contractual obligation" means any obligation under a policy,
contract, or certificate under a group policy or contract, or portion
thereof, for which coverage is provided pursuant to section 10-20-104.
(6)
"Covered policy" means any policy or contract within the scope
of this article.
(7)
"Insolvent insurer" means a member insurer which after July 1,
1991, is placed under an order of liquidation by a court of competent
jurisdiction with a finding of insolvency.
(8)
"Member insurer" means any insurer licensed or who holds a
certificate of authority in this state to write any kind of insurance for
which coverage is provided pursuant to section 10-20-104 and includes any
insurer whose license or certificate of authority in this state may have
been suspended, revoked, not renewed, or voluntarily withdrawn; but
"member insurer" does not include:
(a)
A nonprofit hospital or medical service organization;
(b)
A health maintenance organization;
(c)
A fraternal benefit society;
(d)
A mandatory state pooling plan;
(e)
CoverColorado;
(f)
A stipulated premium insurance company;
(g)
A local mutual burial association;
(h)
A mutual assessment company or any entity that operates on an assessment
basis;
(i)
An interinsurance exchange; and
(j)
Any entity similar to those specified in this subsection (8).
(9)
"Moody's average" means Moody's corporate bond yield average
monthly average corporates as published by Moody's Investors Service,
Inc., or any successor thereto.
(10)
"NAIC" means the national association of insurance
commissioners.
(10.5)
"Owner" of a policy or contract for insurance, or "policy
owner", or "contract owner", means the person who is
identified as the legal owner under the terms of the policy or contract
for insurance or who is otherwise vested with legal title to the policy or
contract for insurance through a valid assignment completed in accordance
with the terms of the policy or contract for insurance and properly
recorded as the owner on the books of the insurer. The terms
"owner", "contract owner", and "policy
owner" do not include persons with a beneficial interest in a policy
or contract.
(11)
"Person" means any individual, corporation, partnership,
association, or voluntary organization.
(12)
"Premiums" means amounts received on covered policies or
contracts less returned premiums, returned considerations, and returned
deposits, and less dividends and experience credits thereon.
"Premiums" does not include any amounts received for any
policies or contracts or for the portions of any policies or contracts for
which coverage is not provided under section 10-20-104 (2); except that
assessable premiums shall not be reduced on account of section 10-20-104
(2) (b) (III) relating to interest limitations and section 10-20-104 (3)
(b) relating to limitations with respect to any one life.
(13)
"Resident" means any person to whom a contractual obligation is
owed and who resides in this state on the date of entry of a court order
that determines a member insurer to be an insolvent insurer. A person may
be a resident of only one state, which in the case of a person other than
a natural person shall be its principal place of business. Citizens of the
United States who are residents of a foreign country, United States
possession, United States territory, or United States protectorate, which
country, possession, territory, or protectorate does not have an
association similar to the association created by this article, shall be
deemed residents of the state of domicile of the insurer that issued the
policies or contracts.
(13.5)
"Structured settlement annuity" means an annuity purchased in
order to fund periodic payments for a plaintiff or other claimant in
payment for or with respect to personal injury suffered by the plaintiff
or other claimant.
(14)
"Supplemental contract" means any agreement entered into for the
distribution of policy or contract proceeds.
(15)
"Unallocated annuity contract" means an annuity contract or
group annuity certificate that is not issued to and owned by an
individual, except to the extent of any annuity benefits guaranteed to an
individual by an insurer under the contract or certificate.
Source:
L. 91: Entire article added, p. 1257, § 1, effective July 1. L. 2000:
(10.5), (13.5), and (15) added and (13) amended, p. 1017, § 1, effective
July 1. L. 2001: (8)(e) amended, p. 1051, § 38, effective July 1. Editor's note: Section 42 of chapter 281, Session
Laws of Colorado 2001, provides that the act amending subsection (8)(e)
applies to health care coverage provided by the program on or after July
1, 2001.
10-20-104
- Coverage and limitations - coordination of benefits.
(1) This article shall provide coverage for the
policies and contracts specified in subsection (2) of this section and to
persons:
(a)
Who are owners of or certificate holders under such policies or contracts,
other than structured settlement annuities, and who:
(I)
Are residents; or
(II)
Are not residents, but only under all of the following conditions:
(A)
The insurer which issued such policies or contracts is domiciled in this
state;
(B)
Such insurer never held a license or certificate of authority in the
states in which such persons reside;
(C)
Such states have associations similar to the association created by this
article; and
(D)
Such persons are not eligible for any amount of coverage by such
associations.
(b)
Regardless of where they reside, except for nonresident certificate
holders under group policies or contracts, who are the beneficiaries,
assignees, or payees of the persons covered under paragraph (a) of this
subsection (1).
(1.3)
Subsection (1) of this section shall not apply to structured settlement
annuities. Except as otherwise provided in subsections (1.5) and (1.7) of
this section, this article shall provide coverage to a person who is a
payee under a structured settlement annuity or to a beneficiary of a
deceased payee if the payee:
(a)
Is a resident, regardless of where the contract owner resides; or
(b)
Is not a resident, but only under both of the following conditions:
(I)
Either:
(A)
The contract owner of the structured settlement annuity is a resident; or
(B)
The contract owner of the structured settlement annuity is not a resident,
but the insurer that issued the structured settlement annuity is domiciled
in this state and the state in which the contract owner resides has an
association similar to the association created by this article; and
(II)
Neither the payee, the beneficiary, nor the contract owner is eligible for
coverage by the association of the state in which the payee or contract
owner resides.
(1.5)
This article shall not provide coverage to a person who is a payee or
beneficiary of a contract owner who is a resident of this state if the
payee or beneficiary is afforded any coverage by the association of
another state.
(1.7)
This article is intended to provide coverage to a person who is a resident
of this state and, in special circumstances, to a nonresident. In order to
avoid duplicate coverage, if a person who would otherwise receive coverage
under this article is provided coverage under the laws of any other state,
the person shall not be provided coverage under this article. In
determining the application of the provisions of this subsection (1.7) in
situations where a person could be covered by the association of more than
one state, whether as an owner, payee, beneficiary, or assignee, this
article shall be construed in conjunction with other state laws to result
in coverage by only one association.
(2)
(a) This article shall provide coverage to the persons specified in
subsection (1) of this section for direct, nongroup life, health, annuity,
and supplemental policies or contracts and for certificates under direct
group life, health, annuity, and supplemental policies and contracts
issued by member insurers pursuant to articles 7 and 8 and parts 1 and 2
of article 16 of this title, except as limited by this article.
(b)
This article shall not provide coverage for:
(I)
Any portion of a policy or contract not guaranteed by the member insurer,
or under which the risk is borne by the policy or contract holder;
(II)
Any policy or contract of reinsurance, unless assumption certificates have
been issued;
(III)
Any portion of a policy or contract to the extent that the rate of
interest on which it is based, or the interest rate, crediting rate, or
other factor employed in calculating returns or changes in value which may
include, without limitation, an index or other external reference stated
in the policy or contract:
(A)
When averaged over the period of four years prior to the date that the
member insurer becomes an insolvent insurer under this article, exceeds a
rate of interest determined by subtracting two percentage points from
Moody's average, averaged for that same four-year period, or for such
lesser period if the policy or contract was issued less than four years
before the member insurer becomes an insolvent insurer under this article;
and
(B)
On and after the date that the member insurer becomes an insolvent insurer
under this article, exceeds the rate of interest determined by subtracting
three percentage points from Moody's average as most recently available;
(IV)
Any plan or program of an employer, association, or similar entity to
provide life, health, or annuity benefits to its employees or members, to
the extent that such plan or program is self-funded or uninsured,
including but not limited to benefits payable by an employer, association,
or similar entity under:
(A)
A multiple employer welfare arrangement, as defined in section 514 of the
federal "Employee Retirement Income Security Act of 1974", as
amended;
(B)
A minimum premium group insurance plan;
(C)
A stop-loss group insurance plan; or
(D)
An administrative services only contract;
(V)
Any portion of a policy or contract to the extent that it provides
dividends or experience rating credits or provides that any fees or
allowances be paid to any person, including the policy or contract holder,
in connection with the service to or administration of such policy or
contract;
(VI)
Any policy or contract issued in this state by a member insurer at a time
when it was not licensed or did not have a certificate of authority to
issue such policy or contract in this state;
(VII)
Any unallocated annuity contract;
(VIII)
Any annuity contract or group annuity certificate which is used by a
nonprofit insurance company exclusively for the benefit of nonprofit
educational institutions and their employees for the purpose of providing
retirement benefits;
(IX)
Any policy, contract, certificate, or subscriber agreement issued by a
prepaid dental care plan as defined in parts 1 and 5 of article 16 of this
title;
(X)
Sickness and accident insurance as defined in section 10-16-102 (30) when
written by a property and casualty insurer as part of an automobile
insurance contract;
(XI)
Any unallocated annuity contract issued to an employee benefit plan
protected under the federal pension benefit guaranty corporation;
(XII)
Any insurer which was insolvent or unable to fulfill its contractual
obligations as of July 1, 1991; except that an annuity contract issued or
assumed by such an insurer shall be covered under this article if such
insurer was ordered into liquidation between July 1, 1991, and August 31,
1991;
(XIII)
Any policy or contract covering persons who are not citizens of the United
States;
(XIV)
Any portion of a policy or contract to the extent it provides for interest
or other changes in value to be determined by the use of an index or other
external reference stated in the policy or contract but such changes have
not been credited to the policy or contract, or to the extent the policy
or contract owner's rights are subject to forfeiture, as of the date the
member insurer becomes an insolvent insurer under to this article. If a
policy's or contract's interest or changes in value are credited less
frequently than annually, then for purposes of determining the values that
have been credited and are not subject to forfeiture under this section,
the interest or change in value determined by using the procedures defined
in the policy or contract shall be credited as if the contractual date of
crediting interest or changing values was the date of insolvency, and such
interest or changes shall not be subject to forfeiture.
(XV)
Any kind of insurance or annuity, the benefits of which are exclusively
payable or determined by a separate account required by the terms of such
insurance policy to be maintained by the insurer or by a separate entity.
(3)
The benefits for which the association may become liable shall not exceed
the lesser of:
(a)
The contractual obligations for which the insurer is liable or would have
been liable if it were not an insolvent insurer; or
(b)
(I) With respect to any one life, regardless of the number of policies or
contracts with that insurer:
(A)
Three hundred thousand dollars in net life insurance death benefits, and
no more than one hundred thousand dollars in net cash surrender and net
cash withdrawal values for life insurance;
(B)
For health insurance benefits: One hundred thousand dollars for coverages
not defined as disability, basic hospital, medical and surgical, or major
medical insurance, including any net cash surrender and net cash
withdrawal values; three hundred thousand dollars for disability
insurance; or five hundred thousand dollars for basic hospital, medical
and surgical, or major medical insurance;
(C)
One hundred thousand dollars in the present value of annuity benefits,
including net cash surrender and net cash withdrawal values; or
(D)
With respect to each payee of a structured settlement annuity, one hundred
thousand dollars in present value annuity benefits, in the aggregate,
including net cash surrender and net cash withdrawal values.
(II)
The association shall not be liable to expend more than three hundred
thousand dollars, in the aggregate, with respect to any one life under
sub-subparagraphs (A) to (D) of subparagraph (I) of this paragraph (b);
except that, with respect to benefits for basic hospital, medical and
surgical, and major medical insurance under sub-subparagraph (B) of
subparagraph (I) of this paragraph (b), the aggregate liability of the
association shall not exceed five hundred thousand dollars with respect to
any one individual.
(4)
The liability of the association is strictly limited by the express terms
of such covered policies and contracts and by the provisions of this
article and is not affected by the contents of any brochures,
illustrations, advertisements, or oral statements by agents, brokers, or
others, used or made in connection with the sale of such covered policies
and contracts. The association is not liable for any extracontractual,
exemplary, or punitive damages, attorney fees, or interest other than as
provided for by the terms of such covered policies or contracts.
Source:
L. 91: Entire article added, p. 1258, § 1, effective July 1. L. 92:
(2)(a), (2)(b)(IX), and (2)(b)(X) amended, p. 1725, § 11, effective July
1. L. 94: (2)(b)(XII) amended, p. 614, § 1, effective April 13. L. 2000:
IP(1)(a), (2)(b)(III), (2)(b)(VII), (2)(b)(XIII), (2)(b)(XIV), and (3)(b)
amended and (1.3), (1.5), and (1.7) added, p. 1018, § 2, effective July
1.
C.J.S.
See 46 C.J.S., Insurance, § § 1122, 1168.
10-20-105
- Construction.
This article shall be construed to effect the purpose
set forth in section 10-20-102, which shall constitute an aid and guide to
interpretation.
Source:
L. 91: Entire article added, p. 1261, § 1, effective July 1.
10-20-106
- Creation of the association.
(1) There is hereby created a private nonprofit legal
entity to be known as the life and health insurance protection
association. All member insurers shall be and remain members of the
association as a condition of their authority to transact insurance in
this state. The association shall perform its functions pursuant to the
plan of operation specified in section 10-20-110 and shall exercise its
powers through the board of directors provided in section 10-20-107. For
purposes of administration and assessment, the association shall maintain
three accounts:
(a)
The life insurance account;
(b)
The health insurance account; and
(c)
The annuity account.
(2)
The association is under the supervision of the commissioner and is
subject to the applicable provisions of the insurance laws of this state.
Meetings or records of the association may be opened to the public
consistent with the provisions of the insurance laws of Colorado.
Source:
L. 91: Entire article added, p. 1261, § 1, effective July 1.
10-20-107
- Board of directors.
(1) The board of directors of the association shall
consist of not less than five nor more than nine member insurers serving
terms as established in the plan of operation. The members of the board
shall be selected by member insurers subject to the approval of the
commissioner. Vacancies on the board shall be filled for the remaining
period of the term by a majority vote of the remaining board members,
subject to the approval of the commissioner. To select the first board and
initially organize the association, the commissioner shall give notice to
all member insurers of the time and place of the organizational meeting.
At the organizational meeting each member insurer shall be entitled to one
vote in person or by proxy. If the board is not selected within sixty days
after notice of the organizational meeting, the commissioner may appoint
the initial members.
(2)
In approving selections or in appointing members to the board, the
commissioner shall consider, among other things, whether all member
insurers are fairly represented.
(3)
Members of the board may be reimbursed from the assets of the association
for expenses incurred by them as members of the board, but members of the
board shall not otherwise be compensated by the association for their
services.
Source:
L. 91: Entire article added, p. 1262, § 1, effective July 1.
10-20-108
- Powers and duties of the association.
(1) In addition to any other powers and duties
provided for in this article, the association has the following powers and
duties:
(a)
If a domestic insurer is an insolvent insurer, the association shall,
subject to the limitations of this article and subject to the approval of
the commissioner:
(I)
Guarantee, assume, or reinsure or cause to be guaranteed, assumed, or
reinsured the covered policies of the insolvent insurer;
(II)
Assure payment of the contractual obligations of the insolvent insurer;
and
(III)
Provide such moneys, pledges, notes, guarantees, or other means as are
reasonably necessary to discharge such duties; or
(b)
With respect to only life and health insurance policies, provide benefits
and coverages in accordance with subsection (3) of this section.
(2)
(a) If a foreign or alien insurer is an insolvent insurer, the association
shall, subject to the approval of the commissioner:
(I)
Guarantee, assume, or reinsure or cause to be guaranteed, assumed, or
reinsured the covered policies of residents;
(II)
Assure payment of the contractual obligations of the insolvent insurer to
the residents; and
(III)
Provide such moneys, pledges, notes, guarantees, or other means as are
reasonably necessary to discharge those duties; or
(IV)
With respect to only life and health insurance policies, provide benefits
and coverages in accordance with subsection (3) of this section.
(b)
This subsection (2) shall not apply if the commissioner has determined
that the foreign or alien insurer's domiciliary jurisdiction or state of
entry provides, by statute, protection substantially similar to that
provided by this article for residents of the state.
(3)
(a) When proceeding under paragraph (b) of subsection (1) or subparagraph
(IV) of paragraph (a) of subsection (2) of this section, the association
shall, with respect to only life and health insurance policies:
(I)
Assure payment of benefits for premiums identical to the premiums and
benefits, except for terms of conversion and renewability, that would have
been payable under the policies of the insolvent insurer for claims
incurred:
(A)
With respect to group policies, not later than the earlier of the next
renewal date under such policies or contracts or forty-five days, but in
no event less than thirty days, after the date on which the association
becomes obligated with respect to such policies;
(B)
With respect to individual policies, not later than the earlier of the
next renewal date, if any, under such policies or one year, but in no
event less than thirty days, after the date on which the association
becomes obligated with respect to such policies;
(II)
Make diligent efforts to provide all known insureds, or group
policyholders with respect to group policies, thirty days notice of the
termination of the benefits provided;
(III)
With respect to individual policies, make available to each known insured
or owner if other than the insured, and with respect to group policies,
make available to each individual formerly insured who is not eligible for
replacement group coverage, substitute coverage on an individual basis in
accordance with the provisions of paragraph (b) of this subsection (3), if
the insureds had a right under law or the terminated policy to convert
coverage to individual coverage or to continue an individual policy in
force until a specified age or for a specified time, during which the
insurer had no right unilaterally to make changes in any provisions of the
policy or had a right only to make changes in premium by class.
(b)
(I) In providing the substitute coverage required under subparagraph (III)
of paragraph (a) of this subsection (3), the association may offer either
to reissue the terminated coverage or to issue an alternative policy.
(II)
Alternative or reissued policies shall be offered without requiring
evidence of insurability and shall not provide for any waiting period or
exclusion that would not have applied under the terminated policy.
(III)
The association may reinsure any alternative or reissued policy.
(c)
(I) Alternative policies adopted by the association shall be subject to
the approval of the commissioner. The association may adopt alternative
policies of various types for future issuance without regard to any
particular insolvency.
(II)
Alternative policies shall contain at least the minimum statutory
provisions required in this state and provide benefits that shall be
reasonably related to the premium charged. The association shall set the
premium in accordance with a table of rates which it shall adopt as
approved by the commissioner. The premium shall reflect the amount of
insurance to be provided and the age and class of risk of each insured but
shall not reflect any changes in the health of the insured after the
original policy was last underwritten.
(III)
Any alternative policy issued by the association shall provide coverage of
a type similar to that of the policy issued by the insolvent insurer, as
determined by the association.
(d)
If the association elects to reissue terminated coverage at a premium rate
different from that charged under the terminated policy, the premium shall
be set by the association in accordance with the amount of insurance
provided and the age and class of risk, subject to approval of the
commissioner or by a court of competent jurisdiction.
(e)
The obligations of the association, with respect to coverage under any
policy of the insolvent insurer or under any reissued or alternative
policy, shall cease on the date such coverage or policy is replaced by
another similar policy by the policyholder, the insured, or the
association.
(4)
When proceeding pursuant to subsection (2) (a) (II) or (2) (b) of this
section, with respect to any policy or contract carrying guaranteed
minimum interest rates, the association shall assure the payment or
crediting of a rate of interest consistent with section 10-20-104 (2) (b)
(III) (A) and (2) (b) (III) (B).
(5)
Nonpayment of premiums within thirty-one days after the date required
under the terms of any guaranteed, assumed, alternative, or reissued
policy or contract or substitute coverage shall terminate the obligations
of the association under such policy or coverage under this article with
respect to such policy or coverage, except with respect to any claims
incurred or any net cash surrender value which may be due in accordance
with the provisions of this article.
(6)
Premiums due for coverage after entry of an order of liquidation of an
insolvent insurer shall belong to and be payable at the direction of the
association, and the association shall be liable for unearned premiums due
to policy contract owners arising after the entry of such order.
(7)
In carrying out its duties under subsections (1) and (2) of this section,
the association may, subject to approval by the court:
(a)
Impose permanent policy or contract liens in connection with any
guarantee, assumption, or reinsurance agreement, if the association finds
that the amounts which can be assessed under this article are less than
the amounts needed to assure full and prompt performance of the duties of
the association under this article, or that the economic or financial
conditions as they affect member insurers are sufficiently adverse to
render the imposition of such permanent policy or contract liens to be in
the public interest;
(b)
Impose temporary moratoriums or liens on payments of cash values and
policy loans, or any other right to withdraw funds held in conjunction
with policies or contracts, in addition to any contractual provisions for
deferral of cash or policy loan value.
(8)
If the association fails to act within a reasonable period of time as
provided in subsections (1), (2), and (3) of this section, the
commissioner shall have the powers and duties of the association under
this article with respect to insolvent insurers.
(9)
There shall be no liability on the part of and no cause of action shall
arise against the association or against any transferee from the
association in connection with the transfer by reinsurance or otherwise of
all or any part of an insolvent insurer's business by reason of any action
taken or any failure to take any action by the insolvent insurer at any
time.
(10)
The association may render assistance and advice to the commissioner, upon
the commissioner's request, concerning payment of claims, continuance of
coverage, the performance of other contractual obligations of any
insolvent insurer, or any member insurer's performance of its contractual
obligations.
(11)
The association shall have standing to appear or intervene before any
court or agency in this state which has jurisdiction over a member insurer
for which the association is or may become obligated under this article,
or with jurisdiction over any person or property against which the
association may have rights through subrogation or otherwise. Such
standing shall extend to all matters germane to the powers and duties of
the association, including but not limited to proposals for reinsuring,
modifying, or guaranteeing the policies or contracts of the member insurer
and the determination of the policies or contracts and contractual
obligations. The association shall also have the right to appear or
intervene before a court or agency in another state with jurisdiction over
a member insurer for which the association is or may become obligated or
with jurisdiction over any person or property against whom the association
may have rights through subrogation or otherwise.
(12)
(a) Any person receiving benefits under this article shall be deemed to
have assigned the rights under, and any causes of action against any
person for losses arising under, resulting from, or otherwise relating to,
the covered policy or contract to the association to the extent of the
benefits received because of this article, whether the benefits are
payments of or on account of contractual obligations, continuation of
coverage, or the provision of substitute or alternative coverage. The
association may require an assignment to it of such rights and causes of
action by any payee, policy, or contract owner, beneficiary, insured, or
annuitant as a condition precedent to the receipt of any right or benefits
conferred by this article upon such person.
(b)
The subrogation rights of the association under this subsection (12) shall
have the same priority against the assets of the insolvent insurer as that
possessed by the person entitled to receive benefits under this article.
(c)
In addition to paragraphs (a) and (b) of this subsection (12), the
association shall have all common-law rights of subrogation and any other
equitable or legal remedy which would have been available to the insolvent
insurer, owner, beneficiary, or payee of a policy or contract with respect
to such policy or contract, including without limitation, in the case of a
structured settlement annuity, any rights of the owner, beneficiary, or
payee of the annuity, to the extent the benefits received pursuant to this
article against a person originally or by succession responsible for the
losses arising from the personal injury relating to the annuity or payment
therefor, excepting any such person responsible solely by reason of
serving as an assignee in respect of a qualified assignment under section
130 of the federal "Internal Revenue Code of 1986", as amended.
(13)
The association may:
(a)
Enter into such contracts as are necessary or proper to carry out the
provisions and purposes of this article;
(b)
Sue or be sued, including taking any legal actions necessary or proper to
recover any unpaid assessments pursuant to section 10-20-109 and to settle
claims or potential claims against it;
(c)
Borrow money to effect the purposes of this article, and any notes or
other evidence of indebtedness of the association not in default shall be
legal investments for domestic insurers and may be carried as admitted
assets;
(d)
Employ or retain such persons as are necessary to handle the financial
transactions of the association and to perform such other functions as
become necessary or proper under this article;
(e)
Take such legal action as may be necessary to avoid payment of improper
claims;
(f)
Exercise, for the purposes of this article and to the extent approved by
the commissioner, the powers of a domestic life or health insurer, but the
association shall not issue insurance policies or annuity contracts other
than those issued to perform its obligations under this article;
(g)
Negotiate and contract with any liquidator or ancillary receiver to carry
out the powers and duties of the association;
(g.5)
Request information from persons seeking coverage from the association in
order to aid the association in determining its obligations under this
article with respect to the person; and a person receiving such request
shall promptly comply;
(g.7)
Take other necessary or appropriate action to exercise its powers and
discharge its duties and obligations under this article;
(h)
With respect to covered policies for which the association becomes
obligated after an entry of an order of liquidation, the association may
elect to succeed to the rights of an insolvent insurer arising after the
date of the order of liquidation under any contract of reinsurance to
which the insolvent insurer was a party, to the extent that such contract
provides coverage for losses occurring after the date of the order of
liquidation. As a condition to making this election, the association shall
pay premiums for coverage relating to periods after the date of the order
of liquidation.
(14)
The association may join an organization of one or more other state
associations of similar purposes to further the purposes and to administer
the powers and duties of the association.
(15)
Every insured or claimant seeking the protection of this article shall
cooperate with the association to the same extent the person or entity
would have been required to cooperate with the insolvent insurer. The
association has no cause of action against the insured of the insolvent
insurer for any sums the association has paid out except those causes of
action the insolvent insurer would have had if the sums had been paid by
the insolvent insurer. If an insolvent insurer operates on a plan with
assessment liability, payments of claims by the association do not reduce
the liability of the insured to the receiver, liquidator, or statutory
successor for unpaid assessments.
(16)
The receiver, liquidator, or statutory successor of an insolvent insurer
is bound by settlements of covered claims by the association or a similar
organization in another state. The association has a claim against the
estate of the insolvent insurer to the extent of claims and expenses paid
by the association in connection with the duties of the association as to
the insolvent insurer. The court having jurisdiction shall grant these
settled claims in the priority to which the claimant would have been
entitled in the absence of this article against the assets of the
insolvent insurer. The expenses, including legal fees of the association
or similar organization in handling claims, shall be given the same
priority as the expenses of the liquidator.
(17)
The association shall periodically file with the liquidator of the
insolvent insurer statements of the covered claims and associated expenses
paid by the association and estimates of anticipated claims against the
association. This periodic filing preserves the rights of the association
for claims against the assets of the insolvent insurer.
(18)
The association shall investigate claims brought against it and adjust,
compromise, settle, and pay covered claims to the extent of the obligation
of the association and deny all other claims.
(19)
A person who has a claim against an insurer pursuant to a provision of an
insurance policy, other than a policy of an insolvent insurer, that also
is a contractual obligation under this article, must first exhaust his
right under that policy. The amount of an approved claim under this
article shall be reduced by the policy limits of, or amount paid under,
that insurance policy, whichever amount is greater. If a claimant exhausts
all rights under a policy other than a policy of an insolvent insurer, the
insurer issuing that policy is not entitled to sue or continue a suit
against the insured of the insolvent insurer to recover an amount paid to
the claimant under the policy; except that a person having a contractual
obligation, as defined by this article, under a life insurance policy or
an annuity contract issued by an insolvent insurer is not required to
exhaust other coverage for that claim, and the amount of an approved claim
under a life insurance policy or annuity contract issued by an insolvent
insurer may not be reduced because of that duplicate coverage.
(20)
Where the association has arranged or offered to provide the benefits of
this article to a covered person under a plan or arrangement that fulfills
the association's obligations under this article, the person shall not be
entitled to benefits from the association in addition to or other than
those provided under the plan or arrangement.
(21)
Venue in a suit against the association arising under this article shall
be in the city and county of Denver. The association shall not be required
to give an appeal bond in an appeal that relates to a cause of action
arising under this article.
(22)
In carrying out its duties in connection with guaranteeing, assuming, or
reinsuring policies or contracts under this section, the association may
issue substitute coverage for a policy or contract that provides for the
calculation of returns or changes in value by the use of an interest rate,
crediting rate, or similar factor determined by use of an index or other
external reference, by issuing an alternative policy or contract in
accordance with the following provisions:
(a)
In lieu of the index or other external reference provided for in the
original policy or contract, the alternative policy or contract provides
for a fixed interest rate, payment of dividends with minimum guarantees,
or a different method for calculating interest or changes in value;
(b)
There is no requirement for the evidence of insurability, a waiting
period, or any other exclusion that would not have applied under the
replaced policy or contact;
(c)
The alternative policy or contract is substantially similar to the
replaced policy or contract in all other material terms.
Source:
L. 91: Entire article added, p. 1262, § 1, effective July 1. L. 94:
IP(3)(a) and (4) amended, p. 1650, § 93, effective May 31. L. 2000: (10),
(11), (12)(a), and (12)(c) amended and (13)(g.5), (13)(g.7), (20), (21),
and (22) added, p. 1020, § § 3, 4, effective July 1.
10-20-109
- Assessments.
(1) For the purpose of providing the funds necessary
to carry out the powers and duties of the association, the board shall
assess each member insurer separately for each account at such time and
for such amounts as the board finds necessary. Assessments shall be due
not less than thirty days after prior written notice to the member
insurers and shall accrue interest at the rate set forth in 28 U.S.C. sec.
1961 on and after the due date.
(2)
There shall be two assessments, as follows:
(a)
Class A assessments shall be made for the purpose of meeting
administrative and legal costs and other expenses and examinations
conducted under the authority of section 10-20-112 (5). Class A
assessments may be made whether or not related to a particular insolvent
insurer.
(b)
Class B assessments shall be made to the extent necessary to carry out the
powers and duties of the association under section 10-20-108 with regard
to an insolvent insurer.
(3)
(a) The amount of any class A assessment shall be determined by the board
and may be made on a non-pro rata basis. A non-pro rata assessment shall
not exceed one hundred fifty dollars per member insurer in any one
calendar year. The amount of any class B assessment shall be allocated for
assessment purposes among the accounts pursuant to an allocation formula
which may be based on the premiums or reserves of the insolvent insurer or
any other standard deemed by the board in its sole discretion to be fair
and reasonable under the circumstances.
(b)
Class B assessments against member insurers for each account shall be in
the proportion that the premiums received on business in this state by
each assessed member insurer on policies or contracts covered by each
account for the three most recent calendar years for which information is
available preceding the year in which the insurer became insolvent, bear
to such premiums received on business in this state for such calendar
years by all assessed member insurers.
(c)
Assessments for funds to meet the requirements of the association with
respect to an insolvent insurer shall not be made until necessary to
implement the purposes of this article. Classification of assessments
under subsection (2) of this section and computation of assessments under
this subsection (3) shall be made with a reasonable degree of accuracy,
recognizing that exact determinations may not always be possible.
(4)
The association may abate or defer, in whole or in part, the assessment of
a member insurer if, in the opinion of the board, payment of the
assessment would endanger the ability of the member insurer to fulfill its
contractual obligations. In the event an assessment against a member
insurer is abated, or deferred in whole or in part, the amount by which
such assessment is abated or deferred may be assessed against the other
member insurers in a manner consistent with the basis for assessments set
forth in this section.
(5)
The total of all assessments upon a member insurer for each account shall
not in any one calendar year exceed one percent of the average premiums
received by such insurer in this state on the policies and contracts
covered by the account during the three calendar years preceding the year
in which the insurer became insolvent. If the maximum assessment, together
with the other assets of the association in any account, does not provide
in any one year in any of the accounts an amount sufficient to carry out
the responsibilities of the association, the necessary additional funds
shall be assessed as soon thereafter as permitted by this article. The
board shall provide in the plan of operation a method of allocating funds
among claims, whether relating to one or more insolvent insurers, when the
maximum assessment will be insufficient to cover anticipated claims.
(6)
The board shall, by an equitable method as established in the plan of
operation, refund to member insurers, in proportion to the contribution of
each insurer to that account, the amount by which the assets of the
account exceed the amount the board finds is necessary to carry out,
during the coming year, the obligations of the association with regard to
that account, including assets accruing from assignment, subrogation, net
realized gains, and income from investments. A reasonable amount shall be
retained in each account to provide funds for the continuing expenses of
the association and for future losses.
(7)
It shall be proper for any member insurer, in determining its premium
rates and policyholder dividends as to any kind of insurance within the
scope of this article, to consider the amount reasonably necessary to meet
its assessment obligations under this article.
(8)
The association shall issue to each insurer paying an assessment for the
life and annuity accounts under this article, other than a class A
assessment, a certificate of contribution from the association, in a form
prescribed by the commissioner, for the amount of the assessment so paid.
All outstanding certificates shall be of equal dignity and priority
without reference to amounts or dates of issue. Such certificate of
contribution may be shown by the insurer in its financial statement as an
asset in such form and for such amount, if any, and period of time as the
commissioner may approve; but the insurer shall, at its option, have the
right in any event to show such certificate of contribution as an admitted
asset at percentages of the original face amount of the assessment for
calendar years as follows:
(a)
One hundred percent for the first year after issuance; and
(b)
One hundred percent less any amount already taken as an offset against
premium tax liability pursuant to section 10-20-113 for the second and
subsequent years after issuance.
(9)
Any member insurer whose certificate of authority has been terminated for
any reason whatsoever shall be liable for any assessment based on
insolvencies arising prior to such termination.
(10)
An assessment is deemed to occur on the date upon which the board votes
such assessment. The board may defer calling the payment of the assessment
or may call for payment in one or more installments.
Source:
L. 91: Entire article added, p. 1269, § 1, effective July 1. L. 2000: (8)
amended, p.1022, § 5, effective July 1.
10-20-110
- Plan of operation.
(1) (a) The association shall maintain a plan of
operation to assure the fair, reasonable, and equitable administration of
the association. The plan of operation and any amendments thereto shall be
submitted to the commissioner and be effective upon the commissioner's
written approval or after thirty days if said commissioner has not
disapproved.
(b)
If the association fails to submit a suitable plan of operation or
suitable amendments to the plan by January 1, 1992, the commissioner
shall, after notice and hearing, adopt and promulgate such reasonable
rules as are necessary or advisable to effectuate the provisions of this
article. Such rules shall continue in force until modified by the
commissioner or superseded by a plan submitted by the association and
approved by the commissioner.
(2)
All member insurers shall comply with the plan of operation.
(3)
The plan of operation shall, in addition to any other provisions specified
in this article:
(a)
Establish procedures for handling the assets of the association;
(b)
Establish the amount and method of reimbursing members of the board
pursuant to section 10-20-107;
(c)
Establish regular places and times for meetings including telephone
conference calls of the board;
(d)
Establish procedures for records to be kept of all financial transactions
of the association, its agents, and the board;
(e)
Establish the procedures whereby selections for the board will be made and
submitted to the commissioner;
(f)
Establish any additional procedures for assessments under section
10-20-109;
(g)
Contain additional provisions necessary or proper for the execution of the
powers and duties of the association.
(4)
The plan of operation may provide that any or all powers and duties of the
association, except those established pursuant to sections 10-20-108 (12)
(c) and 10-20-109, are delegated to a corporation, association, or other
organization which performs, or will perform, functions similar to those
of the association established pursuant to this article, or its equivalent
in two or more states. Such a corporation, association, or organization
shall be reimbursed for any payments made on behalf of the association and
shall be paid for its performance of any function of the association. A
delegation pursuant to this subsection (4) shall take effect only with the
approval of both the board and the commissioner and may be made only to a
corporation, association, or organization which extends protection not
substantially less favorable and effective than that provided by this
article.
(5)
The plan of operation shall establish a procedure for protest by a member
insurer of assessments made by the association pursuant to section
10-20-109. Such procedure shall require that:
(a)
Any member insurer that wishes to protest all or any part of an assessment
for any year shall first pay the full amount of the assessment as set
forth in the notice provided by the association. Such payments shall be
accompanied by a statement in writing that the payment is made under
protest, setting forth a brief statement of the ground for the protest.
The association shall hold such payments in a separate interest-bearing
account.
(b)
Within thirty days following the payment of an assessment under protest by
any protesting member insurer, the association shall notify the member
insurer in writing of its determination with respect to the protest unless
the association notifies the member that additional time is required to
resolve the issues raised by the protest.
(c)
In the event the association determines that the protesting member insurer
is entitled to a refund, such refund shall be made within thirty days
following the date upon which the association makes its determination.
(d)
In the alternative to rendering a decision with respect to any protest
based on a question regarding the assessment base, the association may
refer such protests to the commissioner for final decision, with or
without a recommendation from the association.
(e)
Interest on any refund due a protesting member insurer shall be paid at
the rate actually earned by the association.
Source:
L. 91: Entire article added, p. 1272, § 1, effective July 1.
10-20-111
- Powers and duties of the commissioner.
(1) In addition to any other powers and duties
specified in this article, the commissioner shall:
(a)
Upon request of the board, provide the association with a statement of the
premiums in this and any other appropriate states for each member insurer;
(b)
Notify the board of the existence of an insolvent insurer not later than
three days after a determination of insolvency is made by the
commissioner, irrespective of limitations imposed upon the commissioner in
section 10-3-401;
(c)
In any liquidation proceeding involving a domestic insurer, be appointed
as the liquidator.
(2)
The commissioner may suspend or revoke, after notice and hearing, the
certificate of authority to transact insurance in this state of any member
insurer which fails to pay an assessment when due or fails to comply with
the plan of operation. As an alternative, the commissioner may levy a
forfeiture on any member insurer which fails to pay an assessment when
due. Such forfeiture shall not exceed five percent of the unpaid
assessment per month, but no forfeiture shall be less than one hundred
dollars per month.
(3)
The liquidator of any insolvent insurer shall notify all interested
persons of the effect of this article.
Source:
L. 91: Entire article added, p. 1274, § 1, effective July 1.
10-20-112
- Prevention of insolvencies.
(1) To aid in the detection and prevention of insurer
insolvencies, it shall be the duty of the commissioner:
(a)
To notify the commissioners of all the other states, territories of the
United States, and the District of Columbia when action is taken in any of
the following matters against a member insurer:
(I)
Revocation of license;
(II)
Suspension of license; or
(III)
Issuance of a formal order that such member insurer restrict its premium
writing, obtain additional contributions to surplus, withdraw from the
state, reinsure all or any part of its business, or increase capital,
surplus, or any other account for the security of policyholders or
creditors. Such notice shall be mailed to all commissioners within thirty
days following the action taken or the date on which such action occurs.
(b)
To report to the board when the commissioner has taken any of the actions
set forth in paragraph (a) of this subsection (1) or has received a report
from any other commissioner indicating that such action has been taken in
another state. Such report to the board shall contain all significant
details of the action taken or the report received from another
commissioner.
(c)
To report to the board when the commissioner has reasonable cause to
believe from an examination, whether completed or in process, of a member
company that such member company may be an insolvent insurer;
(d)
To furnish to the board the NAIC insurance regulatory information system
ratios and listings of companies not included in the ratios developed by
the NAIC, and the board may use the information contained therein in
carrying out its duties and responsibilities under this section. Such
report and the information contained therein shall be kept confidential by
the board until such time as made public by the commissioner or other
lawful authority.
(2)
The commissioner may seek the advice and recommendations of the board
concerning any matter affecting said commissioner's duties and
responsibilities regarding the financial condition of member insurers and
companies seeking admission to transact insurance business in this state.
(3)
The board shall, upon request of the commissioner, report and make
recommendations to the commissioner upon any matter germane to the
solvency or liquidation of any member insurer or germane to the solvency
of any company seeking to do an insurance business in this state. Such
reports and recommendations shall not be considered public documents.
(4)
The board shall notify the commissioner when the board has actual
knowledge that an insurer may be insolvent.
(5)
The board shall request that the commissioner order an examination of any
member insurer which the board in good faith believes may be insolvent.
Within thirty days after the receipt of such request, the commissioner
shall begin such examination. The examination may be conducted as an NAIC
examination or may be conducted by such persons as the commissioner
designates. The cost of such examination shall be paid by the association,
and the examination report shall be treated confidentially. In no event
shall such examination report be released to the board prior to its
release to the public, but this shall not preclude the commissioner from
complying with subsection (1) of this section. The commissioner shall
notify the board when the examination is completed. The request for an
examination shall be kept on file by the commissioner, but it shall not be
open to public inspection prior to the release of the examination report
to the public. For purposes of this subsection (5), a "request"
is not a report or recommendation.
(6)
The board may make recommendations to the commissioner for the detection
and prevention of insurer insolvencies.
(7)
The board may, at the conclusion of any insurer insolvency in which the
association was obligated to pay covered claims, prepare a report to the
commissioner containing such information as it may have in its possession
bearing on the history and causes of such insolvency. The board may
cooperate with the boards of directors of guaranty associations in other
states in preparing a report on the history and causes of insolvency of a
particular insurer and may adopt by reference any report prepared by such
other associations.
Source:
L. 91: Entire article added, p. 1274, § 1, effective July 1. L. 2000:
(3), (4), (5), (6), and (7) amended, p. 1023, § 6, effective July 1.
10-20-113 - Credits for assessments paid -
tax offsets.
(1) (a) A member insurer may offset against its
premium tax liability to this state that amount of its class B assessment
described in section 10-20-109 that was assessed for the association's
life and annuity accounts pursuant to section 10-20-106 to the extent of
twenty percent of the amount of such assessment for each of the first,
second, third, fourth, and fifth calendar years following the year in
which such assessment was paid.
(b)
To the extent the offsets specified in paragraph (a) of this subsection
(1) exceed the member insurer's premium tax liability, they may be carried
forward to offset premium tax liabilities in future years. In the event a
member insurer should cease doing business, all uncredited assessments may
be credited against its premium tax liability for the year it ceases doing
business.
(c)
In no event shall the total amount of all such offsets for all member
insurers exceed four million dollars in any year. The association shall
prorate the amount of such offset among all member insurers if the total
amount of offset would otherwise exceed four million dollars in any such
year and shall notify each insurer of the maximum amount of offset
allowable for that year and the amount of the excess offset, if any, that
may be carried forward to future years.
(d)
(I) Each member insurer writing health insurance is required to recoup
over a reasonable length of time a sum reasonably calculated to recoup the
assessments paid by the member insurer under this article by way of a
surcharge on premiums charged for health insurance policies to which this
article applies. Amounts recouped shall not be considered premiums for any
other purpose, including the computation of gross premium tax or agent's
commission.
(II)
The amount of the surcharge shall be filed as part of an insurer's rate
filing pursuant to section 10-16-107 (1). Such surcharge must be shown in
the rate filing as a separate component of the rate and shall include
supporting documentation.
(III)
Such member insurers who collect surcharges in excess of assessments paid
pursuant to this article for an insolvent insurer shall remit the excess
to the association as an additional assessment within one hundred twenty
days after the end of the collection period as determined by the
association. The excess shall be applied to reduce future assessments for
that insurer in the appropriate category.
(IV)
Any such member insurer may omit the collection of the surcharge in any
year from its insureds when the expense of collecting the surcharge in any
such year would exceed the amount of the surcharge. However, nothing in
this paragraph (d) shall relieve the member insurer of its ultimate
obligation to recoup the amount of the surcharge otherwise collectible
from any such previous year.
(2)
Any sums which are acquired by refund pursuant to section 10-20-109 (6)
from the association by member insurers, and which have theretofore been
offset against premium taxes as provided in subsection (1) of this
section, shall be paid by such insurers to this state in such manner as
the tax authorities may require. The association shall notify the
commissioner that such payments have been made.
Source:
L. 91: Entire article added, p. 1276, § 1, effective July 1. L. 92: (1)(d)(II)
amended, p. 1726, § 12, effective July 1. L. 2000: (1)(a) and (1)(c)
amended, p. 1023, § 7, effective July 1.
10-20-114
- Miscellaneous provisions.
(1) Nothing in this article shall be construed to
reduce the liability for unpaid assessments of the insureds of an
insolvent insurer operating under a plan with assessment liability.
(2) Records shall be kept of all negotiations and
meetings in which the association or its representatives are involved to
discuss the activities of the association in carrying out its powers and
duties pursuant to section 10-20-108. Records of such negotiations or
meetings shall be made public only upon the termination of a liquidation
proceeding involving the insolvent insurer, upon the termination of the
insolvency of the insurer, or upon the order of a court of competent
jurisdiction. Nothing in this subsection (2) shall limit the duty of the
association to render a report of its activities under section 10-20-115.
(3)
For the purpose of carrying out its obligations under this article, the
association shall be deemed to be a creditor of the insolvent insurer to
the extent of assets attributable to covered policies reduced by any
amounts to which the association is entitled as assignee or subrogee
pursuant to section 10-20-108 (11). Assets of the insolvent insurer
attributable to covered policies shall be used to continue all covered
policies and pay all contractual obligations of the insolvent insurer as
required by this article. "Assets attributable to covered
policies", as used in this subsection (3), are that proportion of the
assets which the reserves that should have been established for such
policies bear to the reserves that should have been established for all
policies of insurance written by the insolvent insurer.
(4)
(a) Prior to the termination of any liquidation proceeding, the court may
take into consideration the contributions of the respective parties,
including the association, the shareholders, and policyholders of the
insolvent insurer, and any other party with a bona fide interest, in
making an equitable distribution of the ownership rights of such insolvent
insurer. In such a determination, consideration shall be given to the
welfare of the policyholders of the continuing or successor insurer.
(b)
No distribution to stockholders, if any, of an insolvent insurer shall be
made until and unless the total amount of valid claims of the association
with interest thereon for funds expended in carrying out its powers and
duties pursuant to section 10-20-108 with respect to such insurer have
been fully recovered by the association.
(5)
(a) If an order for liquidation of an insurer domiciled in this state has
been entered, the receiver appointed under such order shall have a right
to recover on behalf of the insurer, from any affiliate that controlled
it, the amount of distributions, other than stock dividends paid by the
insurer on its capital stock, made at any time during the five years
preceding the petition for liquidation subject to the limitations of
paragraphs (b) to (d) of this subsection (5).
(b)
No such distribution shall be recoverable if the insurer shows that when
paid the distribution was lawful and reasonable and that the insurer did
not know, and could not reasonably have known, that the distribution might
adversely affect the ability of the insurer to fulfill its contractual
obligations.
(c)
Any person who was an affiliate which controlled the insurer at the time
the distributions were paid shall be liable up to the amount of
distributions such person received. Any person who was an affiliate which
controlled the insurer at the time the distributions were declared shall
be liable up to the amount of the distributions such person would have
received if said distributions had been paid immediately. If two or more
persons are liable with respect to the same distributions, they shall be
jointly and severally liable.
(d)
The maximum amount recoverable under this subsection (5) shall be the
amount needed, in excess of all other available assets of the insolvent
insurer, to pay the contractual obligations of the insolvent insurer.
(e)
If any person liable pursuant to paragraph (c) of this subsection (5) is
insolvent, all of its affiliates which controlled it at the time the
distribution was paid shall be jointly and severally liable for any
resulting deficiency in the amount recovered from the insolvent affiliate.
(6)
Nothing in this article shall be construed to make the state of Colorado
in any way liable for the obligations of the life and health insurance
protection association or the unpaid claims of impaired or insolvent life
and health insurance companies.
Source:
L. 91: Entire article added, p. 1278, § 1, effective July 1.
10-20-115
- Examination of the association - annual report.
The association shall be subject to examination and
regulation by the commissioner. The board shall submit to the commissioner
each year, not later than one hundred twenty days after the close of the
fiscal year of the association, a financial report in a form approved by
the commissioner, and a report of the activities of the board during the
preceding fiscal year.
Source:
L. 91: Entire article added, p. 1280, § 1, effective July 1.
10-20-116 - Tax exemptions.
The association shall be exempt from payment of all
fees and all taxes levied by this state or any of its subdivisions, except
taxes levied on real and personal property.
Source:
L. 91: Entire article added, p. 1280, § 1, effective July 1.
10-20-117
- Immunity.
There shall be no liability on the part of and no
cause of action of any nature shall arise against any member insurer, its
agents, or its employees, the association, its agents, or its employees,
members of the board or the commissioner or his representatives for any
action or omission by them in the performance of their powers and duties
pursuant to this article. Such immunity shall extend to the participation
in any organization of one or more other state associations of similar
purposes and to any such organization and its agents or employees.
Source:
L. 91: Entire article added, p. 1280, § 1, effective July 1.
10-20-118
- Stay of proceedings - reopening default judgments.
All proceedings in which the insolvent insurer is a
party in any court in this state shall be stayed for sixty days after the
date an order of liquidation is final to permit proper legal action by the
association on any matters germane to its powers or duties. As to judgment
under any decision, order, verdict, or finding based on default, the
association may apply to have such judgment set aside by the same court
that issued such judgment and shall be permitted to defend against such
suit on the merits.
Source:
L. 91: Entire article added, p. 1280, § 1, effective July 1.
10-20-119
- Prohibited advertisement of association article in insurance sales -
notice to policyholders.
(1) No person, including an insurer, agent, or
affiliate of an insurer, shall make, publish, disseminate, circulate, or
place before the public, or cause directly or indirectly to be made,
published, disseminated, circulated, or placed before the public, in any
newspaper, magazine, or other publication, or in the form of a notice,
circular, pamphlet, letter, or poster, or over any radio station or
television station, or in any other way, any advertisement, announcement,
or statement, written or oral, which uses the existence of the life and
health insurance protection association for the purpose of sales,
solicitation, or inducement to purchase any form of insurance covered by
the "Life and Health Insurance Protection Association Act".
However, this section shall not apply to the association or any other
entity which does not sell or solicit insurance.
(2)
By December 1, 1991, the association shall prepare a summary document
describing the general purposes and current limitations of this article,
and such summary document shall be in compliance with subsection (3) of
this section. Such summary document shall be submitted to the commissioner
for approval. Sixty days after receiving such approval, each member shall,
when delivering a policy or contract as described in section 10-20-104 (2)
(a) to a policyholder or contract holder, deliver such summary document
concurrently or prior to the delivery of such policy or contract, except
when subsection (4) of this section applies. The summary document shall
also be available upon request by a policyholder. The distribution,
delivery, or contents or interpretation of the summary document shall not
mean that either the policy or the contract or the holder thereof will be
covered in the event of impairment or insolvency of a member insurer. The
summary document shall be revised by the association pursuant to
amendments to this article or as other circumstances may require. Failure
to receive this summary document does not give a policyholder, a contract
holder, or an insured any rights other than those stated in this article.
(3)
The summary document prepared pursuant to subsection (2) of this section
shall contain a clear and conspicuous disclaimer on its face. The
commissioner shall establish the form and content of the disclaimer. The
disclaimer shall:
(a)
State the name and address of the association and the division of
insurance;
(b)
Prominently warn the policyholder or contract holder that the association
may not cover the policy or, if coverage is available, such policy may be
subject to substantial limitations and exclusions and shall be conditioned
on the continued residence in the state by the policyholder or contract
holder;
(c)
State that the insurer and its agents are prohibited by law from using the
existence of the association for the purpose of sales, solicitation, or
inducement to purchase any form of insurance;
(d)
Emphasize that the policyholder or contract holder should not rely on
coverage by the association when selecting an insurer;
(e)
Provide other information as directed by the commissioner.
(4)
No insurer or agent may deliver a policy or contract described in section
10-20-104 (2) (a), but excluded under section 10-20-104 (2) (b) (I) from
coverage under this article, unless the insurer or agent, prior to or at
the time of delivery, gives the policyholder or contract holder a separate
written notice which clearly and conspicuously discloses that the policy
or contract is not covered by the association. The commissioner shall
specify the form and content of the notice.
Source:
L. 91: Entire article added, p. 1280, § 1, effective July 1.
10-20-120 - Prospective application.
This article shall not apply to any insurer which is
declared insolvent before July 1, 1991.
Source:
L. 91: Entire article added, p. 1282, § 1, effective July 1.
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