2019 US Virgin Islands Code
Title 22 - Insurance
Chapter 60 - Third Party Administrators
§ 1524. Maintenance of information

(a) A TPA shall maintain in its principal office and make available to the payor complete books and records of all transactions performed on behalf of the payor. The books and records must be maintained as part of the TPA’s official records in accordance with prudent standards of insurance record keeping and must be maintained during the term of the agreement referenced in section 1526 and for a period of not fewer than five years after the expiration of the agreement.

(b) The Commissioner shall have access to books and records maintained by a TPA for the purposes of examination, audit and inspection. The provisions of chapter 5 of this title apply to the examinations as if the TPA were an insurer under this title. Any information, documents, or other materials in the possession or control of the Commissioner that are furnished by a TPA, payor, insurance producer or an employee or agent thereof acting on behalf of the TPA, payor or insurance producer, or obtained by the Commissioner in an investigation or examination are confidential and privileged, and are not subject to examination by the public, to subpoena, to discovery or admissible in evidence in any private civil action. However, the Commissioner may use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the Commissioner’s official duties.

(c) Neither the Commissioner nor any person who receives documents, materials or other information while acting under the authority of the Commissioner is permitted or required to testify in any private civil action concerning confidential documents, materials, or information subject to be received pursuant to subsection (b).

(d) To assist in the performance of the Commissioner’s duties, the Commissioner may:

• (1) share documents, materials or other information, including the confidential and privileged documents, materials or information subject to subsection (b), with state, federal and international regulatory agencies, with the NAIC, its affiliates or subsidiaries and with state, federal and international law enforcement authorities, if the recipient agrees to maintain the confidentiality and privileged status of the document, material or other information;

• (2) receive documents, materials or information, including otherwise confidential and privileged documents, materials or information, from the NAIC, its affiliates or subsidiaries, and from regulatory and law enforcement officials of other foreign or domestic jurisdictions and shall maintain as confidential or privileged any document, material or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and

• (3) enter into agreements governing sharing and use of information consistent with this section.

(e) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information may occur as a result of disclosure to the Commissioner or as a result of sharing as authorized in subsection (d).

(f) Nothing in this chapter prohibits the Commissioner from releasing final adjudicated actions, including for cause terminations that are open to public inspection pursuant to section 3 V.I.C. 881 or to a database or other clearinghouse service maintained by the NAIC, its affiliates or subsidiaries.

(g) Notwithstanding any contractual agreements between the payor and the TPA which operate to the contrary, the TPA retains the right to sufficient continuing access to books and records to permit the TPA to fulfil all its contractual obligations to insured parties, claimants, and the payor.

(h) If the payor or the TPA cancel their agreement; notwithstanding the provisions of subsection (a), the TPA may, by written agreement with the payor, transfer all records to a new TPA rather than retain them for five years. In such cases, the new TPA must acknowledge in writing, that the TPA is responsible for retaining the records of the old TPA as required in subsection (a).