2016 North Dakota Century Code Title 26.1 Insurance Chapter 26.1-38.1 Life and Health Insurance Guaranty Association
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CHAPTER 26.1-38.1
LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION
26.1-38.1-01. Scope.
1. This section provides coverage for the policies and contracts specified in subsection 2:
a. To persons, except for nonresident certificate holders under group policies or
contracts, who, regardless of where they reside, are the beneficiaries, assignees,
or payees of the persons covered under subdivision b.
b. To persons who are owners of or certificate holders under such policies or
contracts other than unallocated annuity contracts and structured settlement
annuities, and in each case who:
(1) Are residents; or
(2) Are not residents, but only under all of the following conditions:
(a) The insurer that issued such policies or contracts is domiciled in this
state;
(b) The states in which the persons reside have associations similar to
the association created under this chapter; and
(c) The persons are not eligible for coverage by an association in any
other state due to the fact that the insurer was not licensed in the state
at the time specified in the state's guaranty association law.
c. For any unallocated annuity contract specified in subsection 2, subdivisions a and
b do not apply, and this chapter, except as provided in subdivisions e and f,
provides coverage to:
(1) Persons who are the owners of the unallocated annuity contracts if the
contracts are issued to or in connection with a specific benefit plan, the
sponsor of which has its principal place of business in this state; and
(2) Persons who are owners of unallocated annuity contracts issued to or in
connection with government lotteries if the owners are residents.
d. For structured settlement annuities specified in subsection 2, subdivisions a and
b do not apply, and this chapter, except as provided in subdivisions e and f,
provides coverage to a person who is a payee under a structured settlement
annuity or beneficiary of a payee if the payee is deceased, if the payee:
(1) Is a resident, regardless of where the contract owner resides; or
(2) Is not a resident, and:
(a) The contract owner of the structured settlement annuity is a resident,
or 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 under
this chapter; and
(b) Neither the payee or beneficiary nor the contract owner is eligible for
coverage by the association of the state in which the payee or contract
owner resides.
e. This chapter does not provide coverage to:
(1) A person who is a payee or beneficiary of a contract owner resident of this
state, if the payee or beneficiary is afforded any coverage by the association
of another state; or
(2) A person covered under subdivision b, if any coverage is provided by the
association of another state to the person.
f. This chapter provides 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 chapter is provided
coverage under the laws of any other state, the person may not be provided
coverage under this chapter. In determining the application of the provisions of
this subdivision in situations in which a person could be covered by the
association of more than one state, whether as an owner, payee, beneficiary, or
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3.
assignee, this chapter must be construed in conjunction with other state laws to
result in coverage by only one association.
This chapter provides coverage to the persons specified in subsection 1 for direct,
nongroup life, health, or annuity policies or contracts, and supplemental contracts to
any of these, for certificates under direct group policies and contracts, and
supplemental contracts to any of these and for unallocated annuity contracts issued by
member insurers, except as limited by this chapter. Annuity contracts and certificates
under group annuity contracts include guaranteed investment contracts, deposit
administration contracts, unallocated funding agreements, allocated funding
agreements, structured settlement annuities, annuities issued to or in connection with
government lotteries, and any immediate or deferred annuity contracts.
This chapter does not provide coverage for:
a. Any portion of a policy or contract not guaranteed by the insurer, or under which
the risk is borne by the policy owner or contract owner;
b. Any policy or contract of reinsurance, unless assumption certificates have been
issued pursuant to the reinsurance policy or contract;
c. Any portion of a policy or contract to the extent that the rate of interest on which
the portion of the policy or contract is based or to the extent that the rate of
interest, crediting of a rate of interest, or similar factor determined by using an
index or other external reference stated in the policy or contract which is
employed in calculating returns or changes in value:
(1) Averaged over the period of four years prior to the date on which the
member insurer becomes an impaired or insolvent insurer under this
chapter, exceeds a rate of interest determined by subtracting two
percentage points from Moody's corporate bond yield average averaged for
that same four-year period or for such lesser period if the policy or contract
was issued less than four years prior to the date on which the member
insurer becomes an impaired or insolvent insurer under this chapter; and
(2) On and after the date on which the member insurer becomes an impaired or
insolvent insurer under this chapter, exceeds the rate of interest determined
by subtracting three percentage points from Moody's corporate bond yield
average as most recently available;
d. A portion of a policy or contract issued to a plan or program of an employer,
association, or other person to provide life, health, or annuity benefits to its
employees, members, or others, to the extent that such plan or program is
self-funded or uninsured, including benefits payable by an employer, association,
or other person under:
(1) A multiple employer welfare arrangement as defined in 29 U.S.C. 1144;
(2) A minimum premium group insurance plan;
(3) A stop-loss group insurance plan; or
(4) An administrative services only contract;
e. Any portion of a policy or contract to the extent that it provides for dividends or
experience rating credits, voting rights, or payment of any fees or allowances to
any person, including the policy owner or contract owner, in connection with the
service to or administration of such policy or contract;
f. 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;
g. Any unallocated annuity contract issued to or in connection with a benefit plan
protected under the federal pension benefit guaranty corporation regardless of
whether the federal pension benefit guaranty corporation has yet become liable to
make any payments with respect to the benefit plan;
h. Any portion of any unallocated annuity contract which is not issued to, or in
connection with, a specific employee, union, or association of natural persons
benefit plan or a government lottery;
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A portion of a policy or contract to the extent that the assessments required by
section 26.1-38.1-06 with respect to the policy or contract are pre-empted or
otherwise not permitted by federal or state law;
j. An obligation that does not arise under the express written terms of the policy or
contract issued by the insurer to the contract owner or policy owner, including:
(1) Claims based on marketing materials;
(2) Claims based on side letters, riders, or other documents that were issued by
the insurer without meeting applicable policy form filing or approval
requirements;
(3) Misrepresentations of or regarding policy benefits;
(4) Extracontractual claims; or
(5) A claim for penalties or consequential or incidental damages;
k. A contractual agreement that establishes the member insurer's obligations to
provide a book value accounting guaranty for defined contribution benefit plan
participants by reference to a portfolio of assets that is owned by the benefit plan
or its trustee, which in each case is not an affiliate of the member insurer;
l. A 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 which has not been credited to the
policy or contract, or as to which the policy owner's or contract owner's rights are
subject to forfeiture, as of the date the member insurer becomes an impaired or
insolvent insurer under this chapter, whichever is earlier. 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 subdivision, the interest or changes in value determined by
using the procedures defined in the policy or contract will be credited as if the
contractual date of crediting interest or changing values was the date of
impairment or insolvency, whichever is earlier, and is not subject to forfeiture; and
m. A policy or contract providing any hospital, medical, prescription drug, or other
health care benefits pursuant to part C or part D of subchapter XVIII, chapter 7 of
title 42 of the United States Code (commonly known as medicare part C and
part D) or any regulations issued pursuant thereto.
The benefits that the association may become obligated to cover may in no event
exceed the lesser of:
a. The contractual obligations for which the insurer is liable or would have been
liable if it were not an impaired or insolvent insurer;
b. (1) With any respect to one life, regardless of the number of policies, or
contracts:
(a) Three hundred thousand dollars in life insurance death benefits, but
not more than one hundred thousand dollars in net cash surrender
and net cash withdrawal values for life insurance;
(b) In health insurance benefits:
[1] One hundred thousand dollars for coverages not defined as
disability insurance or basic hospital, medical, and surgical
insurance or major medical insurance or long-term care
insurance, including any net cash surrender and net cash
withdrawal values.
[2] Three hundred thousand dollars for disability insurance, and
three hundred thousand dollars for long-term care insurance.
[3] Five hundred thousand dollars for basic hospital, medical, and
surgical insurance or major medical insurance.
(c) Two hundred fifty thousand dollars in the present value of annuity
benefits, including net cash surrender and net cash withdrawal values;
(2) With respect to each individual participating in a government retirement
benefit plan established under section 401(k), 403(b), or 457 of the United
States Internal Revenue Code covered by an unallocated annuity contract
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5.
or the beneficiaries of each such individual if deceased, in the aggregate,
two hundred fifty thousand dollars in present value annuity benefits,
including net cash surrender and net cash withdrawal values;
(3) With respect to each payee of a structured settlement annuity or beneficiary,
or beneficiaries of the payee if deceased, two hundred fifty thousand dollars
in present value annuity benefits, in the aggregate, including net cash
surrender and net cash withdrawal values, if any;
(4) However, in no event shall the association be obligated to cover more than:
(a) An aggregate of three hundred thousand dollars in benefits with
respect to any one life under paragraphs 1, 2, and 3 of subdivision b
except with respect to the benefits for basic hospital, medical, and
surgical insurance and major medical insurance under
subparagraph b of paragraph 1 of subdivision b, in which case the
aggregate liability of the association shall not exceed five hundred
thousand dollars with respect to any one individual; or
(b) With respect to one owner of multiple nongroup policies of life
insurance, whether the persons insured are officers, managers,
employees, or other persons, more than five million dollars in benefits,
regardless of the number of policies and contracts held by the owner.
(5) With respect to either one contract owner provided coverage under
subparagraph c of paragraph 2 of subdivision b of subsection 1; or one plan
sponsor whose plans own directly or in trust one or more unallocated
annuity contracts not included in paragraph 2 of subdivision b, five million
dollars in benefits, irrespective of the number of contracts with respect to the
contract owner or plan sponsor. However, in the case in which one or more
unallocated annuity contracts are covered contracts under this chapter and
are owned by a trust or other entity for the benefit of two or more plan
sponsors, coverage must be afforded by the association if the largest
interest in the trust or entity owning the contract or contracts is held by a
plan sponsor whose principal place of business is in this state and in no
event is the association obligated to cover more than five million dollars in
benefits with respect to all these unallocated contracts.
(6) The limitations set forth in this subsection are limitations on the benefits for
which the association is obligated before taking into account either its
subrogation and assignment rights or the extent to which those benefits
could be provided out of the assets of the impaired or insolvent insurer
attributable to covered policies. The costs of the association's obligations
under this chapter may be met by the use of assets attributable to covered
policies or reimbursed to the association pursuant to its subrogation and
assignment rights.
In performing its obligations to provide coverage under this chapter, the association is
not required to guarantee, assume, reinsure, or perform, or cause to be guaranteed,
assumed, reinsured, or performed, the contractual obligations of the insolvent or
impaired insurer under a covered policy or contract that do not materially affect the
economic values or economic benefits of the covered policy or contract.
26.1-38.1-02. Definitions.
As used in this chapter:
1. "Account" means either of the two accounts created under section 26.1-38.1-03.
2. "Association" means the North Dakota life and health insurance guaranty association
created under section 26.1-38.1-03.
3. "Authorized assessment" or the term "authorized" when used in the context of
assessments means a resolution by the board of directors has been passed under
which an assessment will be called immediately or in the future from member insurers
for a specified amount. An assessment is authorized when the resolution is passed.
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15.
16.
"Benefit plan" means a specific employee, union, or association of natural persons
benefit plan.
"Called assessment" or "called" when used in the context of assessments means that
a notice was issued by the association to member insurers requiring that an authorized
assessment be paid within the timeframe set forth within the notice. An authorized
assessment becomes a called assessment when notice is mailed by the association to
member insurers.
"Commissioner" means the insurance commissioner of this state.
"Contractual obligation" means any obligation under a policy or contract or certificate
under a group policy or contract, or portion thereof for which coverage is provided
under section 26.1-38.1-01.
"Covered policy" means any policy or contract or portion of a policy or contract for
which coverage is provided under this chapter.
"Extracontractual claims" include claims relating to bad faith in the payment of claims,
punitive or exemplary damages, or attorney's fees and costs.
"Impaired insurer" means a member insurer that, after July 1, 1989, is not an insolvent
insurer, and is placed under an order of rehabilitation or conservation by a court of
competent jurisdiction.
"Insolvent insurer" means a member insurer which, after July 1, 1989, is placed under
an order of liquidation by a court of competent jurisdiction with a finding of insolvency.
"Member insurer" means any insurer, including a nonprofit health service corporation,
licensed or which holds a certificate of authority to transact in this state any kind of
insurance for which coverage is provided under section 26.1-38.1-01, and includes
any insurer whose license or certificate of authority in this state may have been
suspended, revoked, not renewed or voluntarily withdrawn, but does not include:
a. A health maintenance organization;
b. A fraternal benefit society;
c. A mandatory state pooling plan;
d. A mutual assessment company or other person that operates on an assessment
basis;
e. A nonprofit health service corporation that is participating in a reinsurance plan
that has been approved by the commissioner as an alternative to participation in
the state guaranty association;
f. An insurance exchange;
g. An organization that has a certificate or license limited to the issuance of
charitable gift annuities under sections 26.1-34.1-01 through 26.1-34.1-07; or
h. Any entity similar to any of the above.
"Moody's corporate bond yield average" means the monthly average corporates as
published by Moody's investors service, incorporated, or any successor thereto.
"Owner" of a policy or contract and "policy owner" and "contract owner" mean the
person who is identified as the legal owner under the terms of the policy or contract or
who is otherwise vested with legal title to the policy or contract through a valid
assignment completed in accordance with the terms of the policy or contract 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 mere beneficial interest in a
policy or contract.
"Person" means any individual, corporation, limited liability company, partnership,
association, governmental entity, or voluntary organization.
"Plan sponsor" means:
a. The employer in the case of a benefit plan established or maintained by a single
employer;
b. The employee organization in the case of a benefit plan established or
maintained by an employee organization; or
c. In the case of a benefit plan established or maintained by two or more employers
or jointly by one or more employers and one or more employee organizations, the
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association, committee, joint board of trustees, or other similar group of
representatives of the parties who establish or maintain the benefit plan.
"Premiums" means amounts or considerations, by whatever name called, received in
any calendar year on covered policies or contracts less returned premiums,
considerations, and deposits, and less dividends and experience credits. "Premiums"
do not include any amounts or considerations received for any policies or contracts or
for the portions of any policies or contracts for which coverage is not provided under
subsections 2 and 3 of section 26.1-38.1-01 and except that assessable premium shall
not be reduced on account of subdivision c of subsection 3 of section 26.1-38.1-01,
relating to interest limitations, and subsection 3 of section 26.1-38.1-01, relating to
limitations with respect to any one individual, any one participant, and any one contract
owner. "Premiums" do not include:
a. Premiums in excess of five million dollars on any unallocated annuity contract not
issued under a governmental retirement plan established under section 401(k),
403(b), or 457 of the United States Internal Revenue Code; or
b. With respect to multiple nongroup policies of life insurance owned by one owner,
whether the policy owner is an individual, firm, corporation, or other person, and
whether the persons insured are officers, managers, employees, or other
persons, premiums in excess of five million dollars with respect to these policies
or contracts, regardless of the number of policies or contracts held by the owner.
"Principal place of business" of a plan sponsor or a person other than a natural person
means the single state in which the natural persons who establish policy for the
direction, control, and coordination of the operations of the entity as a whole primarily
exercise that function, determined by the association in its reasonable judgment by
considering the state in which the primary executive and administrative headquarters
of the entity is located; in which the principal office of the chief executive officer of the
entity is located; in which the board of directors or similar governing person or persons
of the entity conducts the majority of its meetings; in which the executive or
management committee of the board of directors or similar governing person or
persons of the entity conducts the majority of its meetings; from which the
management of the overall operations of the entity is directed; and in the case of a
benefit plan sponsored by affiliated companies comprising a consolidated corporation,
the state in which the holding company or controlling affiliate has its principal place of
business as determined using the above factors. However, in the case of a plan
sponsor, if more than fifty percent of the participants in the benefit plan are employed
in a single state, that state is deemed to be the principal place of business of the plan
sponsor. The principal place of business of a plan sponsor of a benefit plan described
in subdivision c of subsection 16 is deemed to be the principal place of business of the
association, committee, joint board of trustees, or other similar group of
representatives of the parties who establish or maintain the benefit plan that, in lieu of
a specific or clear designation of a principal place of business, is deemed to be the
principal place of business of the employer or employee organization that has the
largest investment in the benefit plan in question.
"Receivership court" means the court in the insolvent or impaired insurer's state having
jurisdiction over the conservation, rehabilitation, or liquidation of the insurer.
"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 impaired insurer or 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 must be its principal place of business.
Citizens of the United States who are residents of foreign countries, or residents of
United States possessions, territories, or protectorates that do not have an association
similar to the association created under this chapter, are deemed residents of the state
of domicile of the insurer that issued the policies or contracts.
"State" means a state, the District of Columbia, Puerto Rico, and a United States
possession, territory, or protectorate.
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"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.
"Supplemental contract" means any written agreement entered into for the distribution
of proceeds under a life, health, or annuity policy or a life, health, or annuity contract.
"Unallocated annuity contract" means any annuity contract or group annuity certificate
which 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 such contract or certificate.
26.1-38.1-03. Creation of the association.
1. There is created a nonprofit legal entity to be known as the North Dakota life and
health insurance guaranty association. All member insurers must 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 under the plan of operation
established and approved under section 26.1-38.1-07 and shall exercise its powers
through a board of directors established under section 26.1-38.1-04. For purposes of
administration and assessment, the association shall maintain two accounts:
a. The life insurance and annuity account that includes the following subaccounts:
(1) Life insurance account;
(2) Annuity account, which includes annuity contracts owned by a governmental
retirement plan or its trustee established under section 401, 403(b), or 457
of the United States Internal Revenue Code, but otherwise excludes
unallocated annuities; and
(3) Unallocated annuity account that excludes contracts owned by a
governmental retirement benefit plan or its trustee established under
section 401, 403(b), or 457 of the United States Internal Revenue Code.
b. The health insurance account.
2. The association shall come under the immediate 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 upon majority vote of the board
of directors of the association.
26.1-38.1-04. 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 must be selected by member insurers, subject to the approval
of the commissioner. Vacancies on the board must 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 initial board of directors, and initially organize the
association, the commissioner shall give notice to all member insurers of the time and
place of the organizational meeting. In determining voting rights of the organizational
meeting, each member insurer is entitled to one vote in person or by proxy. If the
board of directors 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 of directors but members of the
board may not otherwise be compensated by the association for their services.
26.1-38.1-05. Powers and duties of the association.
1. If a member insurer is an impaired insurer, the association may, in its discretion, and
subject to any conditions imposed by the association that do not impair the contractual
obligations of the impaired insurer, and that are approved by the commissioner:
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a.
2.
Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or
reinsured, any or all of the policies or contracts of the impaired insurer; or
b. Provide such moneys, pledges, loans, notes, guarantees, or other means as are
proper to effectuate subdivision a and assure payment of the contractual
obligations of the impaired insurer pending action under subdivision a.
If a member insurer is an insolvent insurer, the association, in its discretion, either
shall:
a. Provide the moneys, pledges, loans, notes, guarantees, or other means as are
reasonably necessary to:
(1) Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or
reinsured, the policies or contracts of the insolvent insurer; or
(2) Assure payment of the contractual obligations of the insolvent insurer; or
b. Provide benefits and coverage in accordance with the following provisions:
(1) With respect to life and health insurance policies and annuities, 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 or contracts of the insolvent insurer, for claims
incurred:
(a) With respect to group policies and contracts, 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 and
contracts.
(b) With respect to nongroup policies, contracts, and annuities, not later
than the earlier of the next renewal date, if any, under such policies or
contracts or one year, but in no event less than thirty days, from the
date on which the association becomes obligated with respect to such
policies or contracts.
(2) Make diligent efforts to provide all known insureds or annuitants for
nongroup policies and contracts, or group policy owners with respect to
group policies and contracts, thirty days' notice of the termination of the
benefits provided.
(3) With respect to nongroup life and health insurance policies and annuities
covered by the association, make available to each known insured or
annuitant, or owner if other than the insured or annuitant, and with respect
to an individual formerly insured or formerly an annuitant under a group
policy who is not eligible for replacement group coverage, substitute
coverage on an individual basis in accordance with the provisions of
paragraph 4, if the insureds or annuitants had a right under law or the
terminated policy or annuity to convert coverage to individual coverage or to
continue an individual policy or annuity in force until a specified age or for a
specified time, during which the insurer had no right unilaterally to make
changes in any provision of the policy or annuity or had a right only to make
changes in premium by class.
(a) In providing the substitute coverage required under this paragraph, the
association may offer either to reissue the terminated coverage or to
issue an alternative policy.
(b) 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.
(c) The association may reinsure any alternative or reissued policy.
(4) Alternative policies adopted by the association shall be subject to the
approval of the domiciliary insurance commissioner and the receivership
court. The association may adopt alternative policies of various types for
future issuance without regard to any particular impairment or insolvency.
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Alternative policies must contain at least the minimum statutory provisions
required in this state and provide benefits that are not unreasonable in
relation to the premium charged. The association shall set the premium in
accordance with a table of rates which it shall adopt. The premium must
reflect the amount of insurance to be provided and the age and class of risk
of each insured, but may not reflect any changes in the health of the insured
after the original policy was last underwritten.
(6) Any alternative policy issued by the association shall provide coverage of a
type similar to that of the policy issued by the impaired or insolvent insurer,
as determined by the association.
(7) If the association elects to reissue terminated coverage at a premium rate
different from that charged under the terminated policy, the premium must
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 domiciliary
insurance commissioner and the receivership court.
(8) The association's obligations with respect to coverage under any policy of
the impaired or 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 policy owner, the insured, or the association.
When proceeding under subsection 2 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 subdivision c of subsection 3 of section
26.1-38.1-01.
Nonpayment of premiums within thirty-one days after the date required under the
terms of any guaranteed, assumed, alternative, or reissued policy or contract of
substitute coverage terminates the association's obligations under such policy or
coverage under this chapter 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 chapter.
Premiums due for coverage after entry of an order of liquidation of an insolvent insurer
belong to and are payable at the direction of the association, and the association is
liable for unearned premiums due to policy or contract owners arising after the entry of
such order.
The protection provided by this chapter does not apply when any guaranty protection
is provided to residents of this state by the laws of the domiciliary state or jurisdiction
of the impaired or insolvent insurer other than this state.
In carrying out its duties under subsection 2, the association may:
a. Subject to approval by a court in this state, 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 chapter
are less than the amounts needed to assure full and prompt performance of the
association's duties under this chapter, 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. Subject to approval by a court in this state, 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 or cash or policy loan value. In addition, in the event of a
temporary moratorium or moratorium charge imposed by the receivership court
on payment of cash values or policy loans, or on any other right to withdraw funds
held in conjunction with policies or contracts, out of the assets of the impaired or
insolvent insurer, the association may defer the payment of cash values, policy
loans, or other rights by the association for the period of the moratorium or
moratorium charge imposed by the receivership court, except for claims covered
by the association to be paid in accordance with a hardship procedure
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established by the liquidator or rehabilitator and approved by the receivership
court.
A deposit in this state, held according to law or as required by the commissioner for
the benefits of creditors, including policy owners, not turned over to the domiciliary
liquidator upon the entry of a final order of liquidation or order approving a
rehabilitation plan of an insurer domiciled in this state or in a reciprocal state, under
section 26.1-06.1-50, must be paid promptly to the association. The association may
retain a portion of any amount received equal to the percentage determined by
dividing the aggregate amount of policy owners' claims related to that insolvency for
which the association has provided statutory benefits by the aggregate amount of all
policy owners' claims in this state related to that insolvency and shall remit to the
domiciliary receiver the amount so paid to the association and retained pursuant to this
subsection. Any amount paid to the association less the amount retained by it is
treated as a distribution of estate assets pursuant to section 26.1-06.1-43 or similar
provision of the state of domicile of the impaired or insolvent insurer.
If the association fails to act within a reasonable period of time with respect to an
insolvent insurer, as provided in subsection 2, the commissioner shall have the powers
and duties of the association under this chapter with respect to insolvent insurers.
The association may render assistance and advice to the commissioner, upon request,
concerning rehabilitation, payment of claims, continuance of coverage, or the
performance of other contractual obligations of any impaired or insolvent insurer.
The association shall have standing to appear or intervene before any court or agency
in this state with jurisdiction over an impaired or insolvent insurer concerning which the
association is or may become obligated under this chapter or with jurisdiction over any
person or property against which the association may have rights through subrogation
or otherwise. Such standing extends to all matters germane to the powers and duties
of the association, including proposals for reinsuring, modifying, or guaranteeing the
policies or contracts of the impaired or insolvent 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 an impaired or insolvent 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.
Any person receiving benefits under this chapter must 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 chapter, whether the
benefits are payments of or on account of contractual obligations, continuation of
coverage, or provision of substitute or alternative coverages. 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 chapter upon such person.
The subrogation rights of the association under this section have the same priority
against the assets of the impaired or insolvent insurer as that possessed by the person
entitled to receive benefits under this chapter.
In addition to subsections 12 and 13, the association shall have all common-law rights
of subrogation and other equitable or legal remedy that would have been available to
the impaired or insolvent insurer or owner, beneficiary, or payee of a policy or contract
with respect to such policy or contract, including, in the case of a structured settlement
annuity, any rights of the owner, beneficiary, or payee of the annuity, to the extent of
benefits received under this chapter, against a person originally or by succession
responsible for the losses arising from or payment for the personal injury relating to the
annuity.
If subsections 12, 13, and 14 are invalid or ineffective with respect to any person or
claim for any reason, the amount payable by the association with respect to the related
covered obligations must be reduced by the amount realized by any other person with
Page No. 10
16.
17.
18.
respect to the person or claim that is attributable to the policies or portion of the
policies covered by the association. If the association has provided benefits with
respect to a covered obligation and a person recovers amounts as to which the
association has rights as described in the preceding paragraphs of this subsection, the
person shall pay to the association the portion of the recovery attributable to the
policies or portion of the policies covered by the association.
In addition to any other rights and powers under this chapter, the association may:
a. Enter into such contracts as are necessary or proper to carry out the provisions
and purposes of this chapter;
b. Sue or be sued, including taking any legal actions necessary or proper to recover
any unpaid assessments under section 26.1-38.1-06 and to settle claims or
potential claims against it;
c. Borrow money to effect the purposes of this chapter and any notes or other
evidences 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 or appropriate to handle the
financial transactions of the association, and to perform such other functions as
become necessary or proper under this chapter;
e. Take such legal action as may be necessary or appropriate to avoid or recover
payment of improper claims;
f. Exercise, for the purposes of this chapter and to the extent approved by the
commissioner, the power of a domestic life or health insurer, but in no case may
the association issue insurance policies or annuity contracts other than those
issued to perform its obligations under this chapter;
g. Organize itself as a corporation or in other legal form permitted by the laws of this
state;
h. Request information from a person seeking coverage from the association in
order to aid the association in determining its obligations under this chapter with
respect to the person, and the person promptly shall comply with the request; and
i. Take other necessary or appropriate action to discharge its duties and obligations
under this chapter or to exercise its powers under this chapter.
The association may join an organization of one or more state associations of similar
purposes, to further the purposes and administer the powers and duties of the
association.
At any time within one year after the date on which the association becomes
responsible for the obligations of a member insurer, the association may elect to
succeed to the rights and obligations of the member insurer which accrue on or after
this coverage date and which relate to contracts covered in whole or in part by the
association under any indemnity reinsurance agreement entered by the member
insurer as a ceding insurer and selected by the association. However, the association
may not exercise an election with respect to a reinsurance agreement if the receiver,
rehabilitator, or liquidator of the member insurer previously and expressly has
disaffirmed the reinsurance agreement. The election is effected by a notice to the
receiver, rehabilitator, or liquidator and to the affected reinsurers. If the association
makes an election, subdivisions a through d apply with respect to the agreements
selected by the association.
a. The association is responsible for all unpaid premiums due under the
agreements, for periods both before and after the coverage date, and is
responsible for the performance of all other obligations to be performed after the
coverage date, in each case which relate to contracts covered, in whole or in part,
by the association. The association may charge contracts covered in part by the
association, through reasonable allocation methods, the costs for reinsurance in
excess of the obligations of the association.
b. The association is entitled to any amounts payable by the reinsurer under the
agreements with respect to losses or events that occur in periods after the
coverage date and that relate to contracts covered by the association, in whole or
Page No. 11
19.
20.
21.
22.
23.
in part, provided that, upon receipt of any of these amounts, the association is
obliged to pay to the beneficiary under the policy or contract on account of which
the amounts were paid a portion of the amount equal to the excess of the amount
received by the association, over the benefits paid by the association on account
of the policy or contract less the retention of the impaired or insolvent member
insurer applicable to the loss or event.
c. Within thirty days following the association's election, the association and each
indemnity reinsurer shall calculate the net balance due to or from the association
under each reinsurance agreement as of the date of the association's election,
giving full credit to every item paid by the member insurer or its receiver,
rehabilitator, or liquidator, or the indemnity reinsurer during the period between
the coverage date and the date of the association's election. The association or
indemnity reinsurer shall pay the net balance due the other within five days of the
completion of the aforementioned calculation. If the receiver, rehabilitator, or
liquidator received any amounts due the association pursuant to subdivision b,
the receiver, rehabilitator, or liquidator shall remit the amounts to the association
as promptly as practicable.
d. If the association, within sixty days of the election, pays the premiums due for
periods both before and after the coverage date that relate to contracts covered
by the association, in whole or in part, the reinsurer may not terminate the
reinsurance agreements, to the extent the agreements relate to contracts covered
by the association, in whole or in part, and may not set off any unpaid premium
due for periods before the coverage date against amounts due the association.
If the association transfers its obligations to another insurer, and if the association and
the other insurer agree, the other insurer shall succeed to the rights and obligations of
the association under subsection 18 effective as of the date agreed by the association
and the other insurer and regardless of whether the association made the election,
provided that:
a. The indemnity reinsurance agreements automatically terminate for new
reinsurance unless the indemnity reinsurer and the other insurer agree to the
contrary;
b. The obligations described in the proviso to subdivision b of subsection 18 no
longer apply on and after the date the indemnity reinsurance agreement is
transferred to the third-party insurer; and
c. This subsection does not apply if the association previously expressly determined
in writing that it will not exercise the election referred to in subsection 18.
Subsections 18 and 19 supersede the provisions of any law of this state or of any
affected reinsurance agreement that provides for or requires any payment of
reinsurance proceeds, on account of losses or events that occur in periods after the
coverage date, to the receiver, rehabilitator, or liquidator, of the insolvent member
insurer. The receiver, rehabilitator, or liquidator remains entitled to any amounts
payable by the reinsurer under the reinsurance agreement with respect to losses or
events that occur in periods before the coverage date, subject to applicable setoff
provisions.
Except as otherwise expressly provided in this section, this section does not alter or
modify the terms and conditions of the indemnity reinsurance agreements of the
insolvent member insurer. This section does not abrogate or limit any rights of any
reinsurer to claim that it is entitled to rescind a reinsurance agreement. This section
does not give a policy owner or beneficiary an independent claim for relief against an
indemnity reinsurer which is not otherwise set forth in the indemnity reinsurance
agreement.
The board of directors of the association has discretion and may exercise reasonable
business judgment to determine the means by which the association is to provide the
benefits of this chapter in an economical and efficient manner.
If the association arranged or offered to provide the benefits of this chapter to a
covered person under a plan or arrangement that fulfills the association's obligations
Page No. 12
24.
25.
under this chapter, the person is not entitled to benefits from the association in addition
to or other than those provided under the plan or arrangement.
The association is not required to give an appeal bond in an appeal that relates to a
cause of action arising under this chapter.
Subject to approval of the receivership court, the association, in carrying out
association duties in connection with guaranteeing, assuming, or reinsuring policies or
contracts under subsections 2 and 3, may issue substitute coverage for a policy or
contract that provides a rate of interest, crediting of a rate of interest, or similar factor
determined by using an index or other external reference stated in the policy or
contract which is employed in calculating returns or changes in value by issuing an
alternative policy or contract if:
a. Instead of the index or other external reference provided in the replaced policy or
contract, the alternative policy or contract provides for a fixed interest rate,
payment of dividends with minimum guarantees, or different method for
calculating interest or changes in value;
b. There is no requirement for evidence of insurability, a waiting period, or other
exclusion that would not have applied under the replaced policy or contract; and
c. The alternative policy or contract is substantially similar to the replaced policy or
contract in all other material terms.
26.1-38.1-06. Assessments.
1. For the purpose of providing the funds necessary to carry out the powers and duties of
the association, the board of directors shall assess the member insurers, separately
for each account, at such time and for such amounts as the board finds necessary.
Assessments must be due not less than thirty days after prior written notice to the
member insurers and must accrue interest at eighteen percent per annum on and after
the due date.
2. There must be two classes of assessment, as follows:
a. Class A assessments must be authorized and called for the purpose of meeting
administrative and legal costs and other expenses. Class A assessments may be
authorized and called whether or not related to a particular impaired or insolvent
insurer.
b. Class B assessments must be authorized and called to the extent necessary to
carry out the powers and duties of the association with regard to an impaired or
insolvent insurer.
3. The amount of any class A assessment must be determined at the discretion of the
board of directors and must be authorized and called on a non-pro rata basis.
4. The amount of any class B assessment must be allocated for assessment purposes
among the accounts pursuant to an allocation formula which may be based on the
premiums or reserves of the impaired or insolvent insurer or any other standard
deemed by the board in its sole discretion as being fair and reasonable under the
circumstances.
5. Class B assessments against member insurers for each account and subaccount must
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 or, in the case of an assessment with respect to
an impaired insurer, the three most recent calendar years for which information is
available preceding the year in which the insurer became impaired, bears to such
premiums received on business in this state for such calendar years by all assessed
member insurers.
6. Assessments for funds to meet the requirements of the association with respect to an
impaired or insolvent insurer may not be authorized or called until necessary to
implement the purposes of this chapter. Classification of assessments under
subsection 2 and computation of assessments under this section must be made with a
reasonable degree of accuracy, recognizing that exact determinations may not always
Page No. 13
7.
8.
9.
10.
11.
12.
13.
be possible. The association shall notify each member insurer of its anticipated
pro rata share of an authorized assessment not yet called within one hundred eighty
days after the assessment is authorized.
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. Once the conditions that caused a deferral are removed or rectified, the
member insurer shall pay all assessments that were deferred pursuant to a repayment
plan approved by the association.
a. Subject to subdivision b, the total of all assessments authorized by the
association with respect to a member insurer for each subaccount of the life
insurance and annuity account and for the health account may not in any one
calendar year exceed two percent of that member insurer's average annual
premiums received in this state on the policies and contracts covered by the
subaccount or account during the three calendar years preceding the year in
which the insurer became an impaired or insolvent insurer.
b. If two or more assessments are authorized in one calendar year with respect to
insurers that become impaired or insolvent in different calendar years, the
average annual premiums for purposes of the aggregate assessment percentage
limitation referenced in subdivision a must be equal and limited to the higher of
the three-year average annual premiums for the applicable subaccount or
account as calculated pursuant to this section.
c. If the maximum assessment, together with the other assets of the association in
an account, does not provide in one year in either account an amount sufficient to
carry out the responsibilities of the association, the necessary additional funds
must be assessed as soon after as permitted under this chapter.
The board may provide in the plan of operation a method of allocating funds among
claims, whether relating to one or more impaired or insolvent insurers, when the
maximum assessment will be insufficient to cover anticipated claims.
If the maximum assessment for any subaccount of the life and annuity account in any
one year does not provide an amount sufficient to carry out the responsibilities of the
association, then pursuant to subsection 7, the board shall assess the other
subaccounts of the life and annuity account for the necessary additional amount,
subject to the maximum stated in subsection 8.
The board may, 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 may be retained in
any account to provide funds for the continuing expenses of the association and for
future claims.
It is proper for any member insurer, in determining its premium rates and policy owner
dividends as to any kind of insurance within the scope of this chapter, to consider the
amount reasonably necessary to meet its assessment obligations under this chapter.
The association shall issue to each insurer paying an assessment under this chapter,
other than a class A assessment, a certificate of contribution, in a form prescribed by
the commissioner, for the amount of the assessment so paid. All outstanding
certificates must be of equal dignity and priority without reference to amounts or dates
of issue. A 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.
Page No. 14
14.
15.
a.
A member insurer that wishes to protest all or part of an assessment shall pay
when due the full amount of the assessment as set forth in the notice provided by
the association. The payment must be available to meet association obligations
during the pendency of the protest or any subsequent appeal. Payment must be
accompanied by a statement in writing that the payment is made under protest
and must set forth a brief statement of the grounds for the protest.
b. Within sixty days following the payment of an assessment under protest by a
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 insurer that additional time is required to resolve the issues raised by the
protest.
c. Within thirty days after a final decision was made, the association shall notify the
protesting member insurer in writing of that final decision. Within sixty days of
receipt of notice of the final decision, the protesting member insurer may appeal
that final action to the commissioner.
d. In the alternative to rendering a final decision with respect to a protest based on a
question regarding the assessment base, the association may refer protests to
the commissioner for a final decision, with or without a recommendation from the
association.
e. If the protest or appeal on the assessment is upheld, the amount paid in error or
excess must be returned to the member insurer. Interest on a refund due a
protesting member shall be paid at the rate actually earned by the association.
The association may request information of member insurers in order to aid in the
exercise of its power under this section and member insurers shall comply promptly
with a request.
26.1-38.1-07. Plan of operation.
1. The association shall submit to the commissioner a plan of operation and any
amendments thereto necessary or suitable to assure the fair, reasonable, and
equitable administration of the association. The plan of operation and any
amendments thereto become effective upon the commissioner's written approval or
after thirty days if the commissioner has not disapproved the plan of operation and any
amendments thereto.
2. If the association fails to submit a suitable plan of operation within one hundred twenty
days following July 1, 1989, or if at any time thereafter the association fails to submit
suitable amendments to the plan, the commissioner shall, after notice and hearing,
adopt such reasonable rules as are necessary or advisable to effectuate the provisions
of this chapter. Such rules must continue in force until modified by the commissioner or
superseded by a plan submitted by the association and approved by the
commissioner.
3. All member insurers shall comply with the plan of operation.
4. The plan of operation must, in addition to requirements enumerated elsewhere in this
chapter:
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 26.1-38.1-04;
c. Establish regular places and times for meetings, including telephone conference
calls of the board of directors;
d. Establish procedures for records to be kept of all financial transactions of the
association, its agents, and the board of directors;
e. Establish the procedures whereby selections for the board of directors will be
made and submitted to the commissioner;
f. Establish any additional procedures for assessments under section 26.1-38.1-06;
g. Contain additional provisions necessary or proper for the execution of the powers
and duties of the association;
Page No. 15
h.
5.
Establish procedures whereby a director may be removed for cause, including if a
member insurer director becomes an impaired or insolvent insurer; and
i. Require the board of directors to establish a policy and procedures for addressing
conflicts of interest.
The plan of operation may provide that any or all powers and duties of the association,
except those under subdivision c of subsection 16 of section 26.1-38.1-05 and section
26.1-38.1-06, are delegated to a corporation, limited liability company, association, or
other organization which performs or will perform functions similar to those of this
association, or its equivalent, in two or more states. Such a corporation, limited liability
company, association, or organization must be reimbursed for any payments made on
behalf of the association and must be paid for its performance of any function of the
association. A delegation under this subsection shall take effect only with the approval
of both the board of directors and the commissioner, and may be made only to a
corporation, limited liability company, association, or organization which extends
protection not substantially less favorable and effective than that provided by this
chapter.
26.1-38.1-08. Duties and powers of the commissioner.
In addition to the duties and powers enumerated elsewhere in this chapter:
1. The commissioner shall:
a. Upon request of the board of directors, provide the association with a statement
of premiums in this and any other appropriate states for each member insurer;
b. When an impairment is declared and the amount of the impairment is determined,
serve a demand upon the impaired insurer to make good the impairment within a
reasonable time; notice to the impaired insurer constitutes notice to its
shareholders, if any; and the failure of the insurer to promptly comply with such
demand does not excuse the association from the performance of its powers and
duties under this chapter; and
c. In any liquidation or rehabilitation proceedings involving a domestic insurer, be
appointed as the liquidator or rehabilitator.
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 may not exceed five percent of the unpaid
assessment per month, but no forfeiture may be less than one hundred dollars per
month.
3. Any final action of the board of directors or the association may be appealed to the
commissioner by any member insurer if such appeal is taken within sixty days of the
member's receipt of notice of the final action being appealed. Any final action or order
of the commissioner is subject to judicial review in a court of competent jurisdiction in
accordance with the laws of this state which apply to the action or orders of the
commissioner.
4. The liquidator, rehabilitator, or conservator of any impaired or insolvent insurer may
notify any interested persons of the effect of this chapter.
26.1-38.1-09. Prevention of insolvencies.
1. To aid in the detection and prevention of insurer insolvencies or impairments, it is 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 the commissioner takes any of the following
actions against a member insurer:
(1) Revokes its license;
(2) Suspends its license; or
(3) Makes any formal order that such company restrict its premium writing,
obtain additional contributions to surplus, withdraw from the state, reinsure
Page No. 16
2.
3.
4.
5.
all or any part of its business, or increase capital, surplus, or any other
account for the security of policy owners or creditors.
(4) Such notice must 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 of directors when the commissioner has taken any of the
actions set forth in subdivision a or has received a report from any other
commissioner indicating that any such action has been taken in another state.
Such report to the board of directors must contain all significant details of the
action taken or the report received from another commissioner.
c. To report to the board of directors when the commissioner has reasonable cause
to believe from any examination, whether completed or in process, of any
member insurer that such insurer may be an impaired or insolvent insurer.
d. To furnish to the board of directors the national association of insurance
commissioners insurance regulation information system ratios and listings of
companies not included in the ratios developed by the national association of
insurance commissioners 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 must be kept confidential by the
board of directors until such time as made public by the commissioner or other
lawful authority.
The commissioner may seek the advice and recommendations of the board of
directors concerning any matter affecting the commissioner's duties and
responsibilities regarding the financial condition of member insurers and companies
seeking admission to transact insurance business in this state.
The board of directors, upon majority vote, may make reports and recommendations to
the commissioner upon any matter germane to the solvency, liquidation, rehabilitation,
or conservation 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
may not be considered public documents.
The board of directors, upon majority vote, may notify the commissioner of any
information indicating any member insurer may be an impaired or insolvent insurer.
The board of directors, upon majority vote, may make recommendations to the
commissioner for the detection and prevention of insurer insolvencies.
26.1-38.1-10. Credits for assessments paid.
1. A member insurer may offset against its premium tax liability to this state an
assessment described in section 26.1-38.1-06 to the extent of twenty percent of the
amount of such assessment for each of the five calendar years following the year in
which such assessment was paid. In the event a member insurer should cease doing
business, all uncredited assessments may be credited against its premiums tax liability
for the year it ceases doing business.
2. Any sums which are acquired by refund, pursuant to section 26.1-38.1-06, from the
association by member insurers, and which have theretofore been offset against
premium taxes as provided in subsection 1, must 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 refunds have been made.
26.1-38.1-11. Miscellaneous provisions.
1. This chapter does not reduce the liability for unpaid assessments of the insured of an
impaired or insolvent insurer operating under a plan with assessment liability.
2. Records must be kept of all meetings of the board of directors to discuss the activities
of the association in carrying out its powers and duties under section 26.1-38.1-05.
The records of the association with respect to an impaired or insolvent insurer may not
be disclosed before the termination of a liquidation, rehabilitation, or conservation
proceeding involving the impaired or insolvent insurer, except upon the order of a court
Page No. 17
3.
4.
5.
6.
7.
of competent jurisdiction. Nothing in this subsection limits the duty of the association to
render a report of its activities under section 26.1-38.1-12.
For the purpose of carrying out its obligations under this chapter, the association must
be deemed to be a creditor of the impaired or insolvent insurer to the extent of assets
attributable to covered policies reduced by any amounts to which the association is
entitled as subrogee pursuant to subsections 12, 13, and 14 of section 26.1-38.1-05.
Assets of the impaired or insolvent insurer attributable to covered policies must be
used to continue as covered policies and pay all contractual obligations of the impaired
or insolvent insurer as required by this chapter. Assets attributable to covered policies,
as used in this subsection, 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 impaired or insolvent
insurer.
As a creditor of the impaired or insolvent insurer as established in subsection 3 and
consistent with chapter 26.1-06, the association and other similar associations are
entitled to receive a disbursement of assets out of the marshaled assets, from time to
time as the assets become available to reimburse it, as a credit against contractual
obligations under this chapter. If the liquidator, within one hundred twenty days of a
final determination of insolvency of an insurer by the receivership court, does not apply
to the court for the approval of a proposal to disburse assets out of marshaled assets
to guaranty associations having obligations because of the insolvency, the association
is entitled to apply to the receivership court for approval of its own proposal to disburse
these assets.
Prior to the termination of any liquidation, rehabilitation, or conservation proceeding,
the court may take into consideration the contributions of the respective parties,
including the association, the shareholders, any policy owners 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 making such a determination,
consideration must be given to the welfare of the policy owners of the continuing or
successor insurer.
No distribution to stockholders, if any, of an impaired or insolvent insurer may 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 under section 26.1-38.1-05
with respect to such insurer have been fully recovered by the association.
a. If an order for liquidation or rehabilitation of an insurer domiciled in this state has
been entered, the receiver appointed under the order has the right to recover on
behalf of the insurer, from any affiliate that controlled its capital stock, 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 or
rehabilitation subject to the limitations of subdivisions b, c, and d.
b. No such distribution is 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 that controlled the insurer at the time the
distributions were paid is liable up to the amount of distributions the person
received. Any person who was an affiliate that controlled the insurer at the time
the distributions were declared is liable up to the amount of distributions the
person would have received if payment had been made immediately. If two or
more persons are liable with respect to the same distributions, they are jointly and
severally liable.
d. The maximum amount recoverable under this subsection is the amount needed in
excess of all other available assets of the insolvent insurer to pay the contractual
obligations of the insolvent insurer.
Page No. 18
e.
If any person liable under subdivision c is insolvent, all its affiliates that controlled
it at the time the distribution was paid, are jointly and severally liable for any
resulting deficiency in the amount recovered from the insolvent affiliate.
26.1-38.1-12. Examination of the association - Annual report.
The association is subject to examination and regulation by the commissioner. The board of
directors shall submit to the commissioner each year, not later than one hundred twenty days
after the association's fiscal year, a financial report in a form approved by the commissioner and
a report of its activities during the preceding fiscal year. Upon the request of a member insurer,
the association shall provide the member insurer with a copy of the report.
26.1-38.1-13. Tax exemptions.
The association is exempt from payment of all fees and all taxes levied by this state on any
of its subdivisions, except taxes levied on real property.
26.1-38.1-14. Immunity.
There is no liability on the part of and no cause of action of any nature may arise against
any member insurer or its agents or employees, the association or its agents or employees,
members of the board of directors, or the commissioner or the commissioner's representatives,
for any action or omission by them in the performance of their powers and duties under this
chapter. Such immunity extends to the participation of any organization of one or more other
state associations of similar purposes and to any such organization and its agents or
employees.
26.1-38.1-15. Stay of proceedings - Reopening default judgments.
All proceedings in which the insolvent insurer is a party in any court in this state must be
stayed one hundred eighty days from the date an order of liquidation, rehabilitation, or
conservation 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
made such judgment and must be permitted to defend against such suit on the merits.
26.1-38.1-16. Prohibited advertisement of Insurance Guaranty Association Act in
insurance sales - Notice to policy owners.
1. No person, including an insurer, insurance producer, or affiliate of an insurer, may
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 insurance guaranty association of this state for the purpose of sales,
solicitation, or inducement to purchase any form of insurance covered by chapter
26.1-38.1. Provided, however, that this section does not apply to the North Dakota life
and health insurance guaranty association or any other entity that does not sell or
solicit insurance.
2. Before January 1, 1990, the association shall prepare a summary document
describing the general purposes and current limitations of the chapter and complying
with subsection 3. This document should be submitted to the commissioner for
approval. Sixty days after receiving approval, no insurer may deliver a policy or
contract to a policy or contract owner unless the summary document is delivered to the
policy or contract owner to or at the time of delivery of the policy or contract. The
document should also be available upon request by a policy owner. The distribution,
delivery, or contents or interpretation of this document does not mean that either the
policy or contract or the owner thereof would be covered in the event of the impairment
or insolvency of a member insurer. The document must be revised by the association
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3.
4.
as amendments to the chapter may require. Failure to receive this document does not
give the policy owner, contract owner, certificate holder, or insured any greater rights
than those stated in this chapter.
The document prepared under subsection 2 must contain a clear and conspicuous
disclaimer on its face. The commissioner shall establish the form and content of the
disclaimer. The disclaimer must:
a. State the name and address of the life and health insurance guaranty association
and insurance department;
b. Prominently warn the policy owner or contract owner that the North Dakota life
and health insurance guaranty association may not cover the policy, or, if
coverage is available, it will be subject to substantial limitations and exclusions
and be conditioned on continued residence in this state;
c. State the types of policies for which guaranty funds will provide coverage;
d. State that the insurer and its insurance producers are prohibited by law from
using the existence of the North Dakota life and health insurance guaranty
association for the purpose of sales, solicitation, or inducement to purchase any
form of insurance;
e. Emphasize that the policy owner or contract owner should not rely on coverage
under the North Dakota life and health insurance guaranty association when
selecting an insurer;
f. Explain rights available and procedures for filing a complaint to allege a violation
of any provisions of this chapter; and
g. Provide other information as directed by the commissioner, including sources for
information about the financial condition of insurers provided the information is
not proprietary and is subject to disclosure under the state's public records law.
A member insurer shall retain evidence of compliance with subsection 2 for so long as
the policy or contract for which the notice is given remains in effect.
26.1-38.1-17. Prospective application.
The amendments to this chapter by chapter 220 of the 2011 Session Laws apply to cases
involving an insolvent insurer which is placed under an order of liquidation with a finding of
insolvency on or after August 1, 2011. For cases involving an insolvent insurer which was
placed under an order of liquidation with a finding of insolvency prior to August 1, 2011, the
provisions of this chapter in effect at the time of the order of liquidation shall apply.
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