NAC683A.510. Handling of claims which agent has authority to settle; suspension and termination of authority to settle claims.

If the contract required pursuant to NAC 683A.470 allows the managing general agent to settle claims on behalf of the insurer:

     1. The managing general agent shall:

     (a) Report all claims to the insurer in a timely manner; and

     (b) Send the insurer a copy of the claim file if the insurer so requests or as soon as the managing general agent knows that the claim:

          (1) Has the potential to exceed an amount determined by the Commissioner or exceeds the limit set by the insurer, whichever is less;

          (2) Involves a coverage dispute;

          (3) May exceed the agent’s authority to settle a claim;

          (4) Is open for more than 6 months; or

          (5) Is closed by payment of an amount set by the Commissioner or an amount set by the insurer, whichever is less.

     2. Except as otherwise provided, all claims files are the joint property of the insurer and managing general agent. Upon an order of liquidation of the insurer, the files become the sole property of the insurer or its estate. The agent may have reasonable access to, and the right to copy the files on a timely basis.

     3. The insurer may terminate any settlement authority granted to the agent:

     (a) For cause upon the insurer’s written notice to the agent; or

     (b) Upon the termination of the contract.

Ê The insurer may suspend the settlement authority during the pendency of any dispute regarding the cause for termination.

     4. The contract must address the timely transmission of information if claims are handled electronically.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)