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H.B. 233 Enrolled
This act modifies the Utah Property and Casualty Guaranty Association Act. The act
establishes a minimum amount for all claims. The act revises definitions, specifically the
definition of a "covered claim." The act addresses net worth test for first-party claims. The
act eliminates per diem but allows expenses for members of the board of directors. The act
addresses the powers and duties of the board of directors. The act addresses termination of
obligations on covered claims. The act allows payment of refunds directly to the State Tax
Commission. The act grants exclusive jurisdiction over claims against the association to the
Utah courts. The act eliminates classes of assessments. The act addresses the plan of
operation of the association. The act clarifies that liability of the association commences with
an order of liquidation. The act addresses the powers and duties of the commissioner. The
act changes the date for submission of the annual report by the association. The act
addresses stay of proceedings and makes technical changes. The act provides a coordination
clause.
This act affects sections of Utah Code Annotated 1953 as follows:
AMENDS:
31A-28-202, as last amended by Chapter 97, Laws of Utah 1988
31A-28-203, as last amended by Chapter 211, Laws of Utah 1991
31A-28-205, as last amended by Chapter 97, Laws of Utah 1988
31A-28-206, as last amended by Chapter 10, Laws of Utah 1997
31A-28-207, as last amended by Chapter 261, Laws of Utah 1989
31A-28-208, as last amended by Chapter 211, Laws of Utah 1991
31A-28-209, as last amended by Chapter 204, Laws of Utah 1986
31A-28-210, as enacted by Chapter 242, Laws of Utah 1985
31A-28-213, as last amended by Chapter 204, Laws of Utah 1986
31A-28-214, as enacted by Chapter 242, Laws of Utah 1985
31A-28-218, as last amended by Chapter 95, Laws of Utah 1987
31A-28-220, as last amended by Chapter 204, Laws of Utah 1986
ENACTS:
31A-28-222, Utah Code Annotated 1953
REPEALS:
31A-28-201, as repealed and reenacted by Chapter 97, Laws of Utah 1988
31A-28-216, as enacted by Chapter 242, Laws of Utah 1985
31A-28-219, as last amended by Chapter 204, Laws of Utah 1986
31A-28-221, as enacted by Chapter 95, Laws of Utah 1987
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 31A-28-202 is amended to read:
31A-28-202. Scope.
This part applies to protect resident policyowners and insureds under all types of direct
insurance, except [
(1) life insurance;
(2) annuity;
(3) health insurance;
(4) disability insurance;
(5) mortgage guaranty insurance;
(6) financial guaranty, or other forms of insurance offering protection against investment
risks;
(7) fidelity or surety bonds, or any other bonding obligation;
(8) credit insurance;
(9) vendor's single interest insurance;
(10) collateral protection insurance, or any similar insurance protecting the interests of a
creditor in a creditor-debtor transaction;
(11) mechanical breakdown insurance, as defined in Section 31A-6a-101 ;
(12) insurance of a warranty or service contract as defined in Section 31A-6a-101 ;
(13) title insurance;
(14) ocean marine insurance;
(15) any transaction between a person and an insurer, or an affiliate of a person or insurer,
that involves the transfer of investment or credit risk unaccompanied by transfer of insurance risk;
or
(16) any insurance provided by or guaranteed by government.
Section 2. Section 31A-28-203 is amended to read:
31A-28-203. Definitions.
As used in this part:
(1) "Affiliate" is as defined in Section 31A-1-301 .
(2) (a) "Claimant" means:
(i) an insured making a first-party claim; or
(ii) a person instituting a liability claim.
(b) A person who is an affiliate of the insolvent insurer may not be a claimant.
[
under a personal lines policy for unearned premiums submitted by a claimant, [
(i) the claim arises out of [
(ii) the claim is within the coverage [
(iii) the claim is not in excess of the applicable limits of an insurance policy to which this
part applies[
(iv) the insurer who issued the policy becomes an insolvent insurer[
(v) (A) the claimant or insured is a resident of this state at the time of the insured event; or
[
(B) the claim is a first-party claim for damage to property that is permanently located in this
state.
(b) "Covered claim" does not include:
(i) any amount awarded as punitive or exemplary damages or any amount due any reinsurer,
insurer, insurance pool, or underwriting association, as subrogation recoveries or otherwise, nor does
it include any supplementary payment obligation, including adjustment fees and expenses, attorneys'
fees and expenses, court costs, interest, and bond premiums, prior to the appointment of a
liquidator[
(ii) any amount sought as a return of premium under a retrospective rating plan;
(iii) any first-party claim by an insured if:
(A) the insured's net worth exceeds $25,000,000 on December 31 of the year preceding the
date the insurer becomes an insolvent insurer; and
(B) the insured's net worth includes the aggregate net worth of the insured and all of its
subsidiaries as calculated on a consolidated basis; or
(iv) any first-party claims by an insured that is an affiliate of the insolvent insurer.
(4) "Insolvent insurer" means a member insurer that is placed under an order of liquidation
by a court of competent jurisdiction with a finding of insolvency.
(5) "Member insurer" means any person who:
(a) writes any kind of insurance to which this part applies under Section 31A-28-202 ,
including the exchange of reciprocal or inter-insurance contracts; and
(b) is licensed to transact insurance in this state.
[
on insurance policies that this part applies to, less return premiums and dividends paid or credited
to policyholders on the direct business.
(b) "Net direct written premiums" does not include premiums on contracts between insurers
or reinsurers.
[
(7) "Personal lines policy" means an insurance policy issued to an individual that:
(a) insures a motor vehicle used for personal purposes and not used in trade or business; or
(b) insures a residential dwelling.
(8) "Residence" means, for entities other than a natural person, the state where the principal
place of business of a claimant, insured, or policyholder is located at the time of the insured event.
Section 3. Section 31A-28-205 is amended to read:
31A-28-205. Creation of the association.
(1) (a) The Utah Property and Casualty Insurance Guaranty Association shall continue as a
nonprofit legal entity.
(b) All member insurers of the association are, and remain, members of the association as
a condition of their authority to transact insurance business in this state.
(c) The association shall:
(i) perform its functions under the plan of operation established and approved under Section
31A-28-209 ; and [
(ii) exercise its powers through a board of directors established under Section 31A-28-206 .
(d) For the purposes of administration and assessment, the association shall maintain:
(i) a workers' compensation insurance account[
(ii) an automobile insurance account[
(iii) a miscellaneous account for all other insurance to which this part applies.
(2) (a) An insurer shall cease to be a member insurer on the day following the termination
or expiration of the insurer's license to transact the kinds of insurance to which this part applies.
(b) Notwithstanding Subsection (2)(a), the insurer shall remain liable as a member insurer
for all obligations, including assessments levied:
(i) before the termination or expiration of the insurer's license; and
(ii) after the termination or expiration of the insurer's license but that relate to an insurer that
became an insolvent insurer before the termination or expiration of the insurer's license.
[
vote of the board of directors of the association.
[
Section 4. Section 31A-28-206 is amended to read:
31A-28-206. Board of directors.
(1) (a) The board of directors of the association consists of not less than five nor more than
nine members, serving terms of four years each.
(b) The members of the board shall be selected by member insurers, subject to the
commissioner's approval. When a vacancy occurs in the membership for any reason, the replacement
shall be elected for the unexpired term by a majority vote of the remaining board members, subject
to the commissioner's approval.
(c) In approving selections or in appointing members to the board, the commissioner shall
consider whether all member insurers are fairly represented.
(d) Notwithstanding [
time of election or reelection, adjust the length of terms to ensure that the terms of board members
are staggered so that approximately half of the board is selected every two years.
[
(2) A member of the board of directors may be reimbursed from the assets of the association
for expenses the member incurs as a member of the board of directors.
[
Section 5. Section 31A-28-207 is amended to read:
31A-28-207. Powers and duties of the association.
(1) (a) The association is obligated on the amount of the covered claims:
(i) existing prior to the [
(ii) arising:
(A) within 30 days after the [
(B) (I) before the policy expiration date if it is less than 30 days after the [
order of liquidation; or
(II) before the insured replaces the policy or causes its cancellation, if [
so within 30 days of the [
(b) The obligation under Subsection (1)(a) includes only that amount of each covered claim
that is [
(c) A claim under a personal lines policy for unearned premiums shall include only those
claims that exceed $100 in amount, subject to a maximum of $10,000 per policy.
(d) The association shall pay the full amount of any covered claim arising out of a
[
a policyholder or claimant in an amount in excess of the obligation of the insolvent insurer under the
policy from which the claim arises.
(e) Any obligation of the association to defend an insured on a covered claim shall cease:
(i) upon payment by the association, as part of a settlement releasing the insured; or
(ii) on a judgment, of the lesser of:
(A) the association's covered claim obligation limit; or
(B) the applicable policy limit.
[
(i) is considered as the insurer only to the extent of its obligation on the covered claims, [
(ii) has all the rights, duties, and obligations of the insolvent insurer as if the insurer had not
yet become insolvent, including the right to pursue and retain salvage and subrogation recoverable
on paid covered claim obligations; and
(iii) may not be considered the insolvent insurer for any purpose relating to whether the
association is subject to personal jurisdiction in the courts of any state.
(g) (i) Notwithstanding any other provisions of this part, except in the case of a claim for
benefits under workers' compensation coverage, any obligation of the association to or on behalf of
a particular insured and its affiliates on covered claims shall cease when:
(A) a total amount of $10,000,000 has been paid to or on behalf of the insured and its
affiliates on covered claims by the association or a similar association; and
(B) all payments on covered claims arise under one or more policies of a single insolvent
insurer.
(ii) The association may establish a plan to allocate the amounts payable by the association
in a manner the association considers equitable if the association determines that:
(A) there is more than one claimant asserting a covered claim against:
(I) the association;
(II) a similar association; or
(III) a property or casualty insurance security fund in another state; and
(B) all claims arise under the policy or policies of a single insolvent insurer.
[
accounts established under Section 31A-28-205 separately, and assess member insurers separately
for each account amounts necessary to pay:
(i) the obligations of the association under Subsection (1)(a), as limited by Subsections (1)(e)
through (g), subsequent to [
(ii) the expenses of handling covered claims subsequent to [
of an insolvent insurer;
(iii) the cost of examinations under Section 31A-28-214 ; and
(iv) other expenses authorized by this part.
[
(A) investigate claims brought against the association; and
(B) adjust, compromise, settle, and pay covered claims to the extent of the association's
obligation and deny all other claims [
[
(ii) The association is not bound by a settlement, release, compromise, waiver, or judgment
executed or entered into by the insolvent insurer:
(A) less than 12 months before the entry of an order of liquidation; or
(B) more than 12 months before the entry of an order of liquidation if the settlement, release,
compromise, waiver, or judgment is:
(I) based on a claim that is not a covered claim; or
(II) the result of fraud, collusion, default, or failure to defend.
(iii) The association may assert all defenses available including defenses applicable to
determining and enforcing the association's statutory rights and obligations to a claim.
(iv) The association may appoint and direct legal counsel retained under a liability insurance
policy for the defense of a covered claim.
[
(A) its employees [
(B) one or more insurers; or
(C) other persons designated as servicing facilities.
(ii) Designation of a servicing facility is subject to the approval of the commissioner, but this
designation may be declined by a member insurer.
[
(i) reimburse each servicing facility for:
(A) obligations of the association paid by the facility; and [
(B) expenses incurred by the facility while handling claims on behalf of the association; and
[
(ii) pay the other expenses of the association as authorized by this title.
(2) The association may:
(a) employ or retain the persons, including private legal counsel, necessary to handle claims
and perform other duties of the association;
(b) borrow funds necessary to implement the purposes of this part in accord with the plan
of operation;
(c) sue or be sued;
(d) negotiate and become a party to the contracts necessary to carry out the purpose of this
part;
(e) perform any other acts necessary or proper to accomplish the purposes of this chapter;
or
(f) refund to the member insurers, in proportion to the contribution of each member insurer
to that account, the amount that the assets of the account exceed the liabilities, if, at the end of any
calendar year, the board of directors finds that:
(i) the assets of the association in any account exceed the liabilities of that account as
estimated by the board of directors for the coming year[
(ii) the excess assets are not needed for other purposes of this part.
(3) For a refund due to a member insurer for an assessment that has been offset against
premium taxes, the association may pay the amount of the refund directly to the State Tax
Commission.
(4) The courts of the state shall have exclusive jurisdiction over all actions brought against
the association that relate to or arise out of this part.
[
person's rights under the policy to the association to the extent of [
the association.
(b) Every insured or claimant seeking the protection of this chapter shall cooperate with the
association to the same extent the person would have been required to cooperate with the insolvent
insurer. [
(c) Except as provided in Subsection (5)(e), 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.
(d) When an insolvent insurer operates on a plan with assessment liability, payments of
claims of the association do not reduce the liability for unpaid assessments of the insurer to:
(i) the receiver[
(ii) liquidator[
(iii) statutory successor [
[
the amount of any "covered claim" paid on behalf of [
(i) any insured whose:
(A) net worth on December 31 of the year next preceding the date the insurer becomes
insolvent, exceeds [
(B) liability obligations to other persons are satisfied in whole or in part by payments made
under this [
(ii) any person:
(A) who is an affiliate of the insolvent insurer; and
(B) whose liability obligations to other persons are satisfied in whole or in part by payments
made under this [
[
by [
(A) a determination of a covered claim eligibility under this part; and
(B) a settlement of a covered [
another state.
(ii) The court having jurisdiction shall grant [
which the claimant would have been entitled to in the absence of this [
assets of the insolvent insurer. [
(g) The association or any similar organization in another state shall:
(i) be recognized as a claimant in the liquidation of an insolvent insurer for any amounts paid
on a covered claim obligation as determined under this part or a similar law in another state; and
(ii) receive dividends or distributions at the priority set forth in Section 31A-27-335 .
[
insolvent insurer[
(A) statements of the covered claims paid by the association; and
(B) estimates of anticipated claims on the association. [
(ii) The filing under this Subsection (5)(h) preserves the rights of the association for claims
against the assets of the insolvent insurer.
[
31A-27-315 and 31A-27-328 , or similar statutes of other states, for filing the same type of claim with
the liquidator of the insolvent insurer.
Section 6. Section 31A-28-208 is amended to read:
31A-28-208. Assessments.
(1) [
association, the board of directors shall assess the member insurers, separately for each account
established under Section 31A-28-205, at the time and in the amount the board finds necessary.
[
(b) An assessment under this section:
(i) is due not less than 30 days after written notice to the member insurers; and [
(ii) accrues interest to the extent unpaid after the due date at the greater of:
(A) 10% per annum[
(B) the then legal rate of interest provided in Section 15-1-1 [
(c) The association shall allocate claims and incurred expenses among the accounts.
[
[
[
amount necessary to carry out the powers and duties of the association under Section [
31A-28-207 for an [
[
[
account [
preceding calendar year on the kinds of insurance in the account bears to the net direct written
premiums of all member insurers for the preceding calendar year on all kinds of insurance in the
account.
[
amount greater than 2% of that member insurer's net direct written premiums for the preceding
calendar year on the kinds of insurance in the account.
[
account, do not provide in any one year in any account an amount sufficient to make all necessary
payments from that account, the funds available shall be prorated and the unpaid portion shall be
paid as soon as funds become available.
[
member insurer, if the assessment would cause the member insurer's financial statement to reflect
amounts of capital or surplus less than the minimum amounts required for a certificate of authority
by any jurisdiction in which the member insurer is authorized to transact insurance.
[
on covered claims and expenses incurred in the payment of the claims by the member insurer, if they
are chargeable to the account for which the assessment is made.
Section 7. Section 31A-28-209 is amended to read:
31A-28-209. Plan of operation.
(1) (a) The association shall submit to the commissioner a plan of operation and any
amendments necessary or suitable to assure the fair, reasonable, and equitable administration of the
association.
(b) The plan of operation and amendments described in Subsection (1)(a) are effective upon
approval in writing by the commissioner.
(c) Any amendments made under this section after July 1, 1986, shall be made within 180
days of the changed circumstance.
(2) The plan of operation shall continue in force until:
(a) modified by the commissioner; or
(b) superseded by a plan:
(i) submitted by the association; and
(ii) approved by the commissioner.
(3) All member insurers shall comply with the plan of operation.
(4) The plan of operation shall, in addition to requirements enumerated elsewhere in this
[
(a) establish procedures for handling the assets of the association;
(b) establish the amount and method of reimbursing members of the board of directors under
Section 31A-28-206 ;
(c) establish regular places and times for meetings of the board of directors;
(d) establish procedures for records to be kept of all financial transactions of the association,
[
(e) establish the procedures on how selections for the board of directors shall be made and
submitted to the commissioner;
(f) establish a procedure for the disposition of dividends or distributions from the estate of
the insolvent insurer;
[
[
execution of the powers and duties of the association.
(5) (a) The plan of operation may provide that any or all of the powers and duties of the
association, except those under Sections 31A-28-207 and 31A-28-208 , are delegated to [
the following that performs functions similar to the association:
(i) a corporation[
(ii) an association[
(iii) organization other than one described in Subsections (5)(a)(i) and (ii). [
(b) A corporation, association, or organization described in Subsection (5)(a) shall:
(i) be reimbursed for any payments made on behalf of the association; and [
(ii) be paid for its performance of any function of the association.
(c) A delegation under this Subsection (5) takes effect only with the approval of [
(i) the board of directors; and
(ii) the commissioner.
Section 8. Section 31A-28-210 is amended to read:
31A-28-210. Duties and powers of the commissioner.
(1) In addition to the duties and powers enumerated elsewhere in this part, the commissioner
shall:
(a) notify the association of the existence of an insolvent insurer not later than three days
after [
liquidation; and
(b) upon request of the board of directors, provide the association with a statement of the
premiums in this state for each member insurer.
[
[
certificate of authority to transact insurance in this state of any member insurer that fails:
(i) to pay an assessment when due; or [
(ii) to comply with the plan of operation or the rules adopted under this part.
(b) (i) As an alternative to an action described in Subsection (2)(a), the commissioner may
levy a fine on any member insurer that fails to pay an assessment when due. [
(ii) The fine [
(A) exceed 5% of the unpaid assessment per month[
(B) be less than $100 per month.
(c) The commissioner may revoke the designation of any servicing facility if [
commissioner finds claims are being handled unsatisfactorily.
(3) Any final action or order of the commissioner under this part is subject to judicial review
in a court of competent jurisdiction.
Section 9. Section 31A-28-213 is amended to read:
31A-28-213. Miscellaneous provisions.
(1) (a) Any person who has a claim against an insurer, whether or not the insurer is a
member insurer, under any provision in an insurance policy, other than a policy of an insolvent
insurer that is also a covered claim, is required to first exhaust [
that person's policy.
(b) Any amount payable on a covered claim under this part under an insurance policy is
reduced by the amount of any recovery under [
(1)(a).
[
may be recovered under more than one insurance guaranty association or its equivalent shall first
seek recovery from the association of the place of residence of the insured. [
(ii) If the person's claim is:
(A) a first-party claim for damage to property with a permanent location, [
shall seek recovery first from the association of the location of the property[
(B) a workers' compensation claim, [
association of the residence of the claimant.
(iii) Any recovery under this part shall be reduced by the amount of recovery from any other
insurance guaranty association or its equivalent.
(2) [
assessments of the insureds of an impaired or insolvent insurer operating under a plan with
assessment liability.
(3) (a) 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 [
association's powers and duties under Section 31A-28-207 . Records of these negotiations or
meetings shall be made public only:
(i) upon the termination of a liquidation, rehabilitation, or conservation proceeding involving
the [
(ii) the termination of the [
(iii) the order of a court of competent jurisdiction.
(b) This Subsection (3) does not limit the duty of the association to render a report of its
activities under Section 31A-28-214 .
(4) For the purpose of carrying out its obligations under this part, the association is
considered to be a creditor of the [
the association is entitled as subrogee under Section 31A-28-207 .
(5) (a) [
proceeding, the court may take into consideration the contributions of the respective parties,
including:
(i) the association[
(ii) the shareholders[
(iii) the policyowners of the insolvent insurer[
(iv) any other party with a bona fide interest, in making an equitable distribution of the
ownership rights of the insolvent insurer.
(b) In making [
court shall [
insurer.
[
not be made until the total amount of valid claims of the association with interest on those claims
for funds expended in carrying out its powers and duties under Section 31A-28-207 regarding this
insurer have been fully recovered by the association.
(6) A rehabilitator, liquidator, or conservator appointed under any section of this [
may recover on behalf of the insurer for excessive distributions paid to affiliates, pursuant to Section
31A-27-322 .
Section 10. Section 31A-28-214 is amended to read:
31A-28-214. Examination of the association -- Annual report.
(1) The association is subject to examination and regulation by the commissioner.
(2) The board of directors shall submit, [
April 30 of each year[
(a) a financial report for the preceding calendar year in a form approved by the commissioner
[
(b) a report of [
Section 11. Section 31A-28-218 is amended to read:
31A-28-218. Stay of proceedings -- Reopening default judgments.
[
association, all proceedings in which the insolvent insurer is a party or is obligated to defend a party
in any court in this state shall be stayed [
claims to permit proper defense by the association of all pending causes of action. [
(2) For any covered [
verdict, or finding based on the default of the insolvent insurer or its failure to defend an insured, the
association either on its own behalf or on behalf of the insured:
(a) may apply to have the judgment[
[
and
(b) shall be permitted to defend against the claim on the merits.
Section 12. Section 31A-28-220 is amended to read:
31A-28-220. Termination of association's operation.
(1) The commissioner shall by order terminate the operation of the [
when [
(a) is a permanent plan that is adequately funded or where adequate funding is provided; or
(b) extends, or will extend to residents and policyholders, protection and benefits regarding
insolvent insurers [
policyholders than the protection and benefits provided regarding the kinds of insurance covered
under this part.
(2) (a) The commissioner shall, by the order under Subsection (1), authorize discontinuance
of future payments by insurers to the [
association regarding the kinds of insurance that are the subject of the order. [
(b) Notwithstanding Subsection (2)(a), the assessments and payments shall continue, as
necessary, to liquidate covered claims of insurers who are adjudged insolvent prior to the order and
to pay the related expenses not covered by any other plan.
(3) (a) If the operation of the [
(1), the association shall, as soon as possible, distribute the balance of monies and assets remaining,
after discharging the functions of the association as to prior insurer insolvencies [
not covered by any other plan, together with related expenses, to the insurers that are then writing
in this state policies of the kinds of insurance covered by this part, and that had made payments to
the association. [
(b) The reimbursement described in Subsection (3)(a) shall be:
(i) pro rata[
(ii) based upon the aggregate of the payments made by the respective insurers during the
period of five years next preceding the date of the order.
(c) For a reimbursement of an assessment that has been offset against premium taxes, the
association may pay the amount of the reimbursement directly to the State Tax Commission.
(d) Upon completion of the distribution regarding all of the kinds of insurance covered by
this part, this part shall terminate.
Section 13. Section 31A-28-222 is enacted to read:
31A-28-222. Application of amendments.
(1) The amendments in this act shall become effective on April 30, 2001 and apply to the
association's obligations under policies of insolvent insurers as they exist on or after April 20, 2001.
(2) Notwithstanding Subsection (1), the amendments to Subsections 31A-28-203 (3) and
31A-28-207 (1)(a) that add coverage for unearned premium claims shall apply only to insurers that
become insolvent after the effective date.
Section 14. Repealer.
This act repeals:
Section 31A-28-201, Purpose.
Section 31A-28-216, Assessment inclusion in premiums.
Section 31A-28-219, Prospective application.
Section 31A-28-221, Insolvencies -- Recommendations and reports of board of directors.
Section 15. Coordination clause.
If this bill and S.B. 100, Insurance Law Amendments, both pass, it is the intent of the
Legislature that in preparing the Utah Code database for publication, the Office of Legislative
Research and General Counsel shall consider that the amendments in Section 31A-28-202 in this bill
supersede the amendments to Section 31A-28-202 in S.B. 100.
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