(1) The Director of the Department of Consumer and Business Services shall suspend, revoke or refuse to renew a license of a third party administrator if the director finds that the third party administrator:
(a) Is in an unsound financial condition;
(b) Is using such methods or practices in the conduct of business so as to render further transaction of business by the third party administrator in this state hazardous or injurious to insured persons or to the public; or
(c) Has failed to pay any judgment rendered against the third party administrator in this state within 60 days after the judgment has become final.
(2) The director may suspend, revoke, refuse to issue or refuse to renew a license of a third party administrator if the director finds one or more of the following with respect to a third party administrator or an applicant for a license therefor:
(a) Falsification by the applicant or licensee of an application for the license or renewal thereof, or engagement in any dishonest act in relation to the application;
(b) Dishonesty, fraud or gross negligence in the transaction of insurance or in the conduct of business as a third party administrator;
(c) Conduct resulting in a conviction of a felony under the laws of any state or of the United States, to the extent that such conduct may be considered under ORS 670.280;
(d) Conviction of any crime, an essential element of which is dishonesty or fraud, under the laws of any state or of the United States;
(e) Refusal to renew or cancellation, revocation or suspension of authority to transact insurance or business as a third party administrator or similar entity in another state;
(f) Failure to pay a civil penalty imposed by final order of the director or to carry out terms of probation set by the director;
(g) Refusal to be examined or to produce accounts, records or files for examination, refusal by any officers to give information with respect to the affairs of the third party administrator or refusal to perform any other legal obligation as to the examination when required by the director;
(h) Affiliation with or under the same general management or interlocking directorate or ownership as another administrator or insurer that unlawfully transacts business in this state;
(i) Failure at any time to meet any qualification for which issuance of the license could have been refused had the failure then existed and been known to the director; or
(j) Violation of any rule or order of the director or any provision of the Insurance Code.
(3) The director may suspend or refuse to renew a license immediately and without hearing if the director determines that one or more of the following circumstances exist:
(a) The third party administrator is insolvent;
(b) A proceeding for receivership, conservatorship or rehabilitation or other delinquency proceeding regarding the third party administrator has been commenced in any state; or
(c) The financial condition or business practices of the third party administrator otherwise pose an imminent threat to the public health, safety or welfare of the residents of this state.
(4) A third party administrator holding a license that has not been renewed or has been revoked shall surrender the license to the director at the director’s request.
(5) The director may take any other administrative action authorized under the Insurance Code in addition to or in lieu of the actions authorized under this section. [1991 c.812 §11]Section: Previous 744.704 744.706 744.708 744.710 744.712 744.714 744.716 744.718 744.720 744.722 744.724 744.726 744.728 744.730 744.732 Next
Last modified: August 7, 2008