TITLE XXXVII
INSURANCE

CHAPTER 402-H
THIRD PARTY ADMINISTRATORS

Section 402-H:14

    402-H:14 Grounds for Denial, Suspension, or Revocation of Certificate of Authority. –
I. The certificate of authority or license of an administrator shall be denied, suspended, or revoked if the commissioner finds that the administrator:
(a) Is in an unsound financial condition.
(b) Is using such methods or practices in the conduct of its business so as to render its further transaction of business in this state hazardous or injurious to insured persons or the public.
(c) Has failed to pay any judgment rendered against it in this state within 60 days after the judgment has become final.
II. The commissioner may deny, suspend, or revoke the certificate of authority or license of an administrator if the commissioner finds that the administrator:
(a) Has violated any lawful rule or order of the commissioner or any provision of the insurance laws of this state.
(b) Has refused to be examined or to produce its accounts, records and files for examination, or if any individual responsible for the conduct of affairs of the administrator, including members of the board of directors, board of trustees, executive committee, or other governing board or committee; the principal officers in the case of a corporation or the partners or members in the case of a partnership, association, or limited liability company; any shareholder or member holding directly or indirectly 10 percent or more of the voting stock, voting securities, or voting interest of the administrator; and any other person who exercises control or influence over the affairs of the administrator; has refused to give information with respect to its affairs or has refused to perform any other legal obligation as to such examination, when required by the commissioner.
(c) Has, without just cause, refused to pay proper claims or perform services arising under its contracts or has, without just cause, caused covered individuals to accept less than the amount due them or caused covered individuals to employ attorneys or bring suit against the administrator to secure full payment or settlement of such claims.
(d) At any time fails to meet any qualification for which issuance of the certificate could have been refused had such failure then existed and been known to the commissioner.
(e) Or any of the individuals responsible for the conduct of its affairs, including members of the board of directors, board of trustees, executive committee, or other governing board or committee; the principal officers in the case of a corporation or the partners or members in the case of a partnership, association, or limited liability company; any shareholder or member holding directly or indirectly 10 percent or more of its voting stock, voting securities, or voting interest; and any other person who exercises control or influence over its affairs; has been convicted of, or has entered a plea of guilty or nolo contendere to, a felony without regard to whether adjudication was withheld.
(f) Is under suspension or revocation in another state.
(g) Has failed to timely file its annual report.
III. The commissioner may, without advance notice or hearing, immediately suspend the certificate of authority or license of an administrator if the commissioner finds that one or more of the following circumstances exist:
(a) The administrator is insolvent or impaired.
(b) A proceeding for receivership, conservatorship, rehabilitation, or other delinquency proceeding regarding the administrator has been commenced in any state.
(c) The financial condition or business practices of the administrator otherwise pose an imminent threat to the public health, safety or welfare of the residents of this state.
IV. If the commissioner finds that one or more grounds exist for the suspension or revocation of a certificate of authority issued under this section, the commissioner may, in lieu of suspension or revocation, impose a fine upon the administrator.

Source. 1993, 253:1. 2006, 271:12, eff. Aug. 8, 2006.