North Carolina General Statutes 58-57-115. Family leave credit insurance standards; policy provisions
(a) Definitions. – As used in this section:
(1) “Foster child” means a minor (i) over whom a guardian has been appointed by the clerk of superior court of any county in North Carolina; or (ii) the primary or sole custody of whom has been assigned by order of a court of competent jurisdiction.
Terms Used In North Carolina General Statutes 58-57-115
- Creditor: means any lender of money or vendor or lessor of goods, services, property, rights or privileges, including any person that directly or indirectly provides credit in connection with any such sale or lease, for which payment is arranged through a credit-related transaction; or any successor to the right, title or interest of any such lender, vendor, lessor, or person extending credit, and an affiliate, associate, or subsidiary of any of them, or any director, officer, or employee of any of them or any other person in any way associated with any of them. See North Carolina General Statutes 58-57-5
- Debtor: means a borrower of money or a purchaser or lessee of goods, services, property, rights or privileges for which payment is arranged through a credit transaction. See North Carolina General Statutes 58-57-5
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- following: when used by way of reference to any section of a statute, shall be construed to mean the section next preceding or next following that in which such reference is made; unless when some other section is expressly designated in such reference. See North Carolina General Statutes 12-3
- Grand jury: agreement providing that a lender will delay exercising its rights (in the case of a mortgage,
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Indebtedness: means the total amount payable for the term of the loan by debtor to creditor in connection with a loan or other credit transaction, including principal, interest, allowable charges, and any premiums authorized hereunder. See North Carolina General Statutes 58-57-5
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- 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.
(2) “Immediate family member” means a spouse, child (natural, adopted, or foster), or parent of the insured person.
(3) “Placement in the foster home” means physically residing with the insured person appointed as the guardian or custodian of a foster child or children as long as the insured person has assumed the legal obligation for total or partial support of the foster child or children with the intent that the foster child or children reside with the insured person on more than a temporary or short-term basis.
(b) Coverage. – Insurers may provide coverage for loss of income because of a voluntary, employer-approved leave of absence granted upon the occurrence of any of the qualifying events in subsection (d) of this section. The insured person shall not be required to meet any federal requirements in order to qualify for benefits provided by this coverage. Benefits shall be paid to the creditor to reduce the insured person’s indebtedness.
(c) Eligibility. – Coverage may be provided or offered to any debtor who has not yet reached his or her 71st birthday and has been working for wages for at least 30 hours per week for the past five consecutive weeks.
(d) Qualifying Events. – Benefits shall be paid only for the following qualifying events:
(1) An accident involving sickness of, or incapacitation of, an immediate family member that requires the insured person to attend to the family member’s needs.
(2) Birth of a child or children of the insured person.
(3) Adoption of a child or children of the insured person.
(4) Placement in the foster home of a foster child or children.
(5) The insured person’s principal residence is in a federally declared disaster area.
(6) The insured person is called to active military duty.
(7) The insured person is called to petit or grand jury duty.
(e) Exclusions. – Coverage shall not contain any exclusions except:
(1) Retirement of the insured person from employment.
(2) Voluntary resignation of the insured person from employment.
(3) Seasonal unemployment of the insured person.
(4) Involuntary unemployment of the insured person.
(5) Disability of the insured person.
(6) Employment termination because of willful or criminal misconduct of the insured person.
(f) Notice. – The insurer shall send a notice to the insured person at the insured person’s home address to inform the insured person that benefits have been paid, including the dates and the amount of payment. The notice shall be sent to the insured person within 60 days after the last day of the benefit period.
(g) Minimum Amounts. – The minimum monthly benefit amount shall be level for the entire benefit period. The minimum monthly benefit amount shall equal or exceed the minimum monthly payment required by the creditor, plus the premium charge for the coverage attributable to the benefit period.
(h) Miscellaneous Provisions. – Any waiting period for benefits shall not exceed 30 days. The insured shall provide satisfactory evidence of employer approval of qualified leave. Lump-sum benefits may be paid. Refunds of unearned single premiums shall be equal to the pro rata unearned gross premium.
(i) Rates. – Premium rates shall be actuarially demonstrated to generate a sixty percent (60%) incurred loss ratio. Joint coverage rates shall be one and two-thirds (1 2/3) times the approved single rate. Rates shall be filed for approval before they can be used.
(j) Reports. – By March 31 of each year every insurer writing family leave coverage shall file a statistical report of the past calendar year’s actuarial experience for that coverage. The report shall demonstrate the actual experience loss ratio for the calendar year and shall include the: number of insureds, total earned premium, total number of incurred claims, total incurred claims, total number of incurred claims for each qualifying event, average monthly benefit per claim for each qualifying event, and premium refunds. (1999-351, s. 5.1.)