Sec. 11.5. (a) The association is not obligated to pay a first party claim by a high net worth insured described in section 4(a)(5)(A) of this chapter.

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Terms Used In Indiana Code 27-6-8-11.5

  • association: means the Indiana Insurance Guaranty Association created by section 5 of this chapter. See Indiana Code 27-6-8-4
  • 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: means the commissioner of insurance of this state. See Indiana Code 27-6-8-4
  • covered claim: means an unpaid claim which arises out of and is within the coverage and not in excess of the applicable limits of an insurance policy to which this chapter applies issued by an insurer, if the insurer becomes an insolvent insurer after the effective date (January 1, 1972) of this chapter and (a) the claimant or insured is a resident of this state at the time of the insured event or (b) the property from which the claim arises is permanently located in this state. See Indiana Code 27-6-8-4
  • high net worth insured: means the following:

    Indiana Code 27-6-8-4

  • insolvent insurer: means (a) a member insurer holding a valid certificate of authority to transact insurance in this state either at the time the policy was issued or when the insured event occurred and (b) against whom a final order of liquidation, with a finding of insolvency, to which there is no further right of appeal, has been entered by a court of competent jurisdiction in the company's state of domicile. See Indiana Code 27-6-8-4
  • 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.
  • person: means an individual, an aggregation of individuals, a corporation, a partnership, or another entity. See Indiana Code 27-6-8-4
     (b) The association has the right to recover from a high net worth insured described in section 4(a)(5)(B) of this chapter all amounts paid by the association to or on behalf of the high net worth insured, regardless of whether the amounts were paid for indemnity, defense, or otherwise.

     (c) The association is not obligated to pay a claim that:

(1) would otherwise be a covered claim;

(2) is an obligation to or on behalf of a person who has a net worth greater than the net worth allowed by the insurance guaranty association law of the state of residence of the claimant at the time specified by the applicable law of the state of residence of the claimant; and

(3) has been denied by the association of the state of residence of the claimant on the basis described in subdivision (2).

     (d) The association shall establish reasonable procedures, subject to the approval of the commissioner, for requesting financial information from insureds:

(1) on a confidential basis; and

(2) in the application of this section.

     (e) The procedures established under subsection (d) must provide for sharing of the financial information obtained from insureds with:

(1) any other association that is similar to the association; and

(2) the liquidator for an insolvent insurer;

on the same confidential basis.

     (f) If an insured refuses to provide financial information that is:

(1) requested under the procedures established under subsection (d); and

(2) available;

the association may, until the time that the financial information is provided to the association, consider the insured to be a high net worth insured for purposes of subsections (a) and (b).

     (g) In an action contesting the applicability of this section to an insured that refuses to provide financial information under the procedures established under subsection (d), the insured bears the burden of proof concerning the insured’s net worth at the relevant time. If the insured fails to prove that the insured’s net worth at the relevant time was less than the applicable amount set forth in section 4(a)(5)(A) or 4(a)(5)(B) of this chapter, the court shall award to the association the association’s full costs, expenses, and reasonable attorney‘s fees incurred in contesting the claim.

As added by P.L.52-2013, SEC.8. Amended by P.L.158-2024, SEC.22.

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