§36-1474. Written contract with insurer required - Minimum
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provisions.
No person acting in the capacity of a managing general agent shall place business with an insurer unless there is in force a written contract between the parties which sets forth the responsibilities of each party, and where both parties share
responsibility for a particular function, specifies the division of such responsibilities, and which contains the following minimum provisions:
1. The insurer may terminate the contract for cause upon thirty
(30)days' written notice to the managing general agent and the Insurance Commissioner. The insurer may suspend the underwriting authority of the managing general agent during the pendency of any dispute regarding the cause for termination;
2. The managing general agent shall render accounts to the insurer detailing all transactions and shall remit all funds due under the contract to the insurer on not less than a monthly basis;
3. All funds collected for the account of an insurer shall be held by the managing general agent in a fiduciary capacity in a bank which is a member of the Federal Reserve System. This account shall be used for all payments on behalf of the insurer. The managing general agent may retain no more than three
(3)months' estimated claims payment and allocated loss adjustment expenses;
4. Separate records of business written by the managing general agent shall be maintained. The insurer shall have access to and the right to copy all accounts and records related to its business in a form usable by the insurer. The Insurance Commissioner shall have access to all books, bank accounts and records of the managing general agent in a form usable to the Commissioner. Such records shall be retained according to the provisions of subsection E of Section 1435.13 of this title;
5. The contract may not be assigned in whole or part by the managing general agent;
6. The contract shall contain appropriate underwriting guidelines including:
a. the maximum annual premium volume,
b. the basis of the rates to be charged,
c. the types of risks which may be written,
d. maximum limits of liability,
e. applicable exclusions,
f. territorial limitations,
g. policy cancellation provisions, and
h. the maximum policy period;
7. The insurer shall have the right to cancel or not renew any policy of insurance subject to applicable laws and regulations;
8. If the contract permits the managing general agent to settle claims on behalf of the insurer:
a. all claims must be reported to the company in a timely
manner,
b. a copy of the claim file shall be sent to the insurer
at its request or as soon as it becomes known that the
claim:
has the potential to exceed a threshold
determined by the Insurance Commissioner or
exceeds the limit set by the company, whichever
is less,
(2)involves a coverage dispute,
(3)may exceed the managing general agent's claims
settlement authority,
(4)is open for more than six
(6)months, or
(5)is closed by payment of an amount set by the
Insurance Commissioner or an amount set by the
company, whichever is less,
c. all claim files will be the joint property of the
insurer and managing general agent. However, upon an
order of liquidation of the insurer, such files shall
become the sole property of the insurer or its estate
and the managing general agent shall have reasonable
access to and the right to copy the files on a timely
basis,
d. any settlement authority granted to the managing
general agent may be terminated for cause upon the
insurer's written notice to the managing general agent
or upon the termination of the contract. The insurer
may suspend the settlement authority during the
pendency of any dispute regarding the cause for
termination, and
e. nothing in this section shall be construed to give the
Insurance Commissioner authority to settle or adjust
claims on behalf of the insurer;
9. Where electronic claim files are in existence, the contract shall address the timely transmission of the data;
10. If the contract provides for a sharing of interim profits by the managing general agent, and the managing general agent has the authority to determine the amount of the interim profits by establishing loss reserves or controlling claim payments, or in any other manner, interim profits will not be paid to the managing general agent on the lines of business written by the managing general agent until at least ninety-seven percent (97%) of the ultimate loss has been developed for those lines of business, based on an opinion of the actuary who certifies the adequacy of the loss reserves for the insurer;
11. The managing general agent shall not:
a. bind reinsurance or retrocessions on behalf of the
insurer, except that the managing general agent may
bind facultative reinsurance contracts pursuant to
obligatory facultative agreements if the contract with
the insurer contains reinsurance underwriting
guidelines including, for both reinsurance assumed and
ceded:
(1)a list of reinsurers with which such automatic
agreements are in effect,
(2)the coverages and amounts or percentages that may
be reinsured, and
(3)commission schedules,
b. commit the insurer to participate in insurance or
reinsurance syndicates,
c. appoint any agent or broker without assuring that the
agent or broker is lawfully licensed to transact the
type of insurance for which he is appointed,
d. without prior approval of the insurer, pay or commit
the insurer to pay a claim over a specified amount,
net of reinsurance, which shall not exceed one percent
(1%) of the insurer's policyholder's surplus as of
December 31 of the last completed calendar year,
e. collect any payment from a reinsurer or commit the
insurer to any claim settlement with a reinsurer
without prior approval of the insurer. If prior
approval is given, a report shall be promptly
forwarded to the insurer,
f. permit its sub-agent or sub-broker to serve on the
insurer's board of directors,
g. jointly employ an individual who is employed with the
insurer, or
h. appoint a sub-managing general agent. Added by Laws 1991, c. 134, § 4, eff. July 1, 1991. Amended by Laws 2002, c. 307, § 23, eff. Nov. 1, 2002.