Managers: Requirements for settlement of claims; ownership of claims files; termination of authority to settle claims.
1. If a contract between a manager for reinsurance and the reinsurer he represents permits him to settle claims on behalf of the reinsurer:
(a) All claims must be reported to the reinsurer in a timely manner; and
(b) A copy of the claim file must be sent to the reinsurer at its request or as soon as it becomes known that the claim:
(1) Potentially exceeds the amount determined by the Commissioner or the limit set by the reinsurer, whichever is the lesser amount;
(2) Involves a dispute over coverage;
(3) May exceed the authority of the manager for reinsurance to settle claims;
(4) Has been open for more than 6 months; or
(5) Is closed by payment of the lesser of an amount set by the Commissioner or an amount set by the reinsurer.
2. All claims files are the joint property of the reinsurer and the manager for reinsurance. Upon an order of liquidation of the reinsurer, the files become the sole property of the reinsurer or its estate. The reinsurer or its estate shall allow the manager for reinsurance to have reasonable access to and to copy the files on a timely basis.
3. The reinsurer may terminate any authority to make settlements granted to the manager for reinsurance for cause upon written notice to him or upon the termination of the contract. The reinsurer may suspend the authority of the manager for reinsurance to make settlements during the pendency of the dispute regarding the cause of termination.
Last modified: February 27, 2006