Indiana Code 27-1-25-12.4. Denial, suspension, or revocation of administrator license
(1) is in unsound financial condition;
Terms Used In Indiana Code 27-1-25-12.4
- Administrator: means a person who directly or indirectly and on behalf of an insurer underwrites, collects charges or premiums from, or adjusts or settles claims on residents of Indiana in connection with life, annuity, or health coverage offered or provided by an insurer. See Indiana Code 27-1-25-1
- Attorney: includes a counselor or other person authorized to appear and represent a party in an action or special proceeding. See Indiana Code 1-1-4-5
- Commissioner: refers to the insurance commissioner appointed under IC 27-1-1-2. See Indiana Code 27-1-25-1
- Control: means the direct or indirect possession of the power to direct or cause the direction of the management and policies of a person, whether:
Indiana Code 27-1-25-1
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- corporation: means an insurance company and includes all persons, partnerships, corporations, associations, orders or societies engaged in or proposing to engage in making any kind of insurance authorized by the laws of this state. See Indiana Code 27-1-2-3
- Covered individual: means an individual who is covered under a benefit program provided by an insurer. See Indiana Code 27-1-25-1
- Insurance: means a contract of insurance or an agreement by which one (1) party, for a consideration, promises to pay money or its equivalent or to do an act valuable to the insured upon the destruction, loss or injury of something in which the other party has a pecuniary interest, or in consideration of a price paid, adequate to the risk, becomes security to the other against loss by certain specified risks; to grant indemnity or security against loss for a consideration. See Indiana Code 27-1-2-3
- Judgment: means all final orders, decrees, and determinations in an action and all orders upon which executions may issue. See Indiana Code 1-1-4-5
- member: means one who holds a contract of insurance or is insured in an insurance company other than a stock corporation. See Indiana Code 27-1-2-3
- Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
- Person: has the meaning set forth in Indiana Code 27-1-25-1
- Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
- shareholder: means one who is a holder of record of shares of stock in a corporation, unless the context otherwise requires. See Indiana Code 27-1-2-3
(3) fails to pay a judgment rendered against the administrator in Indiana not more than sixty (60) days after the judgment is final and all appeals have been exhausted.
(b) The commissioner may deny, suspend, or revoke a license issued under this chapter if the commissioner determines that:
(1) the administrator has violated a lawful rule or order of the commissioner or a provision of the insurance laws of Indiana;
(2) the administrator refuses to be examined or to produce the administrator’s accounts, records, and files for examination;
(3) an individual who is responsible for the conduct of the affairs of the administrator, including:
(A) a member of the administrator’s:
(i) board of directors;
(ii) board of trustees;
(iii) executive committee; or
(iv) other governing board or committee;
(B) a principal officer, if the administrator is a corporation;
(C) a partner or member, if the administrator is:
(i) a partnership;
(ii) an association; or
(iii) a limited liability company;
(D) a shareholder or member that holds, directly or indirectly, ten percent (10%) or more of the:
(i) voting stock;
(ii) voting securities; or
(iii) voting interest;
of the administrator; or
(E) any other person who exercises control or influence over the affairs of the administrator;
refuses to provide information with respect to the administrator’s business or to perform another legal obligation with respect to an examination when required by the commissioner;
(4) the administrator, without just cause:
(A) refuses to pay proper claims or to perform services arising under a written agreement;
(B) causes a covered individual to accept less than the amount due to the covered individual; or
(C) causes a covered individual to employ an attorney or bring suit against the administrator to secure full payment or settlement of a proper claim;
(5) the administrator fails to meet a qualification for which issuance of the administrator’s license could have been refused if the failure had existed and been known by the commissioner at the time of license issuance;
(6) an individual who is responsible for the conduct of the affairs of the administrator, including:
(A) a member of the administrator’s:
(i) board of directors;
(ii) board of trustees;
(iii) executive committee; or
(iv) other governing board or committee;
(B) a principal officer, if the administrator is a corporation;
(C) a partner or member, if the administrator is:
(i) a partnership;
(ii) an association; or
(iii) a limited liability company;
(D) a shareholder or member that holds, directly or indirectly, ten percent (10%) or more of the:
(i) voting stock;
(ii) voting securities; or
(iii) voting interest;
of the administrator; or
(E) any other person who exercises control or influence over the affairs of the administrator;
is convicted of or enters a plea of guilty or nolo contendere to a felony, without regard to whether adjudication is withheld;
(7) the administrator’s license has been suspended or revoked in another state; or
(8) the administrator fails to timely file the:
(A) report required under section 12.3 of this chapter; or
(B) statement and pay the filing fee required under section 12.2(e) of this chapter.
(c) The commissioner may, in the commissioner’s discretion and without advance notice or hearing, immediately suspend the license of an administrator if the commissioner finds one (1) or more of the following:
(1) The administrator is insolvent or financially impaired.
(2) A proceeding for receivership, conservatorship, rehabilitation, or other delinquency proceeding regarding the administrator has been commenced in any state.
(3) The financial condition or business practices of the administrator pose an imminent threat to the public health, safety, or welfare of residents of Indiana.
(d) If the commissioner determines that cause exists for the suspension or revocation of a license issued under this chapter, the commissioner may, instead of suspension or revocation, impose a civil penalty not to exceed twenty-five thousand dollars ($25,000) per act or violation upon the administrator. A civil penalty imposed under this subsection may be enforced in the same manner as a civil judgment. Civil penalties collected under this subsection shall be deposited in the state general fund.
As added by P.L.160-2003, SEC.18.