Florida Regulations 69O-187.003: Approval of Service Agent Required
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Any Service Agent shall be approved by the Office prior to use by the Fund. The Service Agent shall provide proof that it meets the following conditions before approval may be granted:
(1) The owner(s) of the Service Agent, including members of a copartnership, the officers of a corporation, and any person exercising control or influence over the affairs of the Service Agent, must not have been convicted of a felony or of any crime involving fraud, embezzlement, or theft nor have been an officer, Trustee or Service Agent or Administrator in a self-insurance funded plan that has become insolvent.
(2) The Service Agent shall certify that it either employs or contracts with a sufficient number of experienced and qualified claims personnel to meet the needs of the self-insurance trust fund with which it intends to contract.
(3) The Service Agent shall certify that it employs or contracts with a sufficient number of personnel experienced and qualified in the area of underwriting to meet the needs of the self-insurance trust fund with which it intends to contract or to provide the contractual arrangement made to have such service provided. In this context, the term “”underwriting”” includes, but is not limited to, the overall planning and coordinating of the self-insurance trust fund, the ability to procure excess insurance, the ability to provide summary data regarding the cost of claims, including the frequency and distribution of claims by type and cause, and the skill to make recommendations to individual members regarding the correction of any deficiencies that arise in the self-insurance trust fund.
(4) The Service Agent shall submit information concerning its organization and staff sufficient to establish fulfillment of the requirements of this section.
(5) The Service Agent shall certify that it has the recordkeeping capabilities specified before any approval may be granted.
(6) The Service Agent shall submit biographical statements on the form entitled “”Biographical Statement,”” which is included in the “”Application for Approval as a Medical Malpractice Self-Insurance Trust Fund,”” Form OIR-370; and fingerprint cards for all persons who have first line responsibility for the operation or management of all or part of the Fund, including but not limited to the principal executive and operating officers of the Service Agent. Form OIR-370 is hereby incorporated by reference and shall become effective on May 10, 1989. Form OIR-370 may be obtained from the Office of Insurance Regulation, Bureau of Property and Casualty Forms and Rates, Larson Building, Tallahassee, Florida 32399-0300.
Rulemaking Authority Florida Statutes § 627.357(6), 624.308(1) FS. Law Implemented 624.307(1), 627.357 FS. History-New 5-10-89, Formerly 4-39.0021, 4-187.003.
Terms Used In Florida Regulations 69O-187.003
- Contract: A legal written agreement that becomes binding when signed.
- 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.
- Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. Source: OCC
- Fraud: Intentional deception resulting in injury to another.
- Trustee: A person or institution holding and administering property in trust.
(2) The Service Agent shall certify that it either employs or contracts with a sufficient number of experienced and qualified claims personnel to meet the needs of the self-insurance trust fund with which it intends to contract.
(3) The Service Agent shall certify that it employs or contracts with a sufficient number of personnel experienced and qualified in the area of underwriting to meet the needs of the self-insurance trust fund with which it intends to contract or to provide the contractual arrangement made to have such service provided. In this context, the term “”underwriting”” includes, but is not limited to, the overall planning and coordinating of the self-insurance trust fund, the ability to procure excess insurance, the ability to provide summary data regarding the cost of claims, including the frequency and distribution of claims by type and cause, and the skill to make recommendations to individual members regarding the correction of any deficiencies that arise in the self-insurance trust fund.
(4) The Service Agent shall submit information concerning its organization and staff sufficient to establish fulfillment of the requirements of this section.
(5) The Service Agent shall certify that it has the recordkeeping capabilities specified before any approval may be granted.
(6) The Service Agent shall submit biographical statements on the form entitled “”Biographical Statement,”” which is included in the “”Application for Approval as a Medical Malpractice Self-Insurance Trust Fund,”” Form OIR-370; and fingerprint cards for all persons who have first line responsibility for the operation or management of all or part of the Fund, including but not limited to the principal executive and operating officers of the Service Agent. Form OIR-370 is hereby incorporated by reference and shall become effective on May 10, 1989. Form OIR-370 may be obtained from the Office of Insurance Regulation, Bureau of Property and Casualty Forms and Rates, Larson Building, Tallahassee, Florida 32399-0300.
Rulemaking Authority Florida Statutes § 627.357(6), 624.308(1) FS. Law Implemented 624.307(1), 627.357 FS. History-New 5-10-89, Formerly 4-39.0021, 4-187.003.