GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1999

H	1 

HOUSE BILL 306

Short Title:  Insurance Amendments/AB.	(Public)

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Sponsors: Representatives Hardaway; and Hurley.

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Referred to:  Insurance.

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March 4, 1999

A BILL TO BE ENTITLED
AN ACT TO AUTHORIZE THE COMMISSIONER OF INSURANCE TO CONDUCT HEARINGS AND ADOPT CERTAIN RULES RELATED TO THE BEACH AND FAIR PLANS, TO AUTHORIZE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO APPROVE ADDITIONAL BEDS FOR CONTINUING CARE RETIREMENT FACILITIES UNDER CERTAIN CIRCUMSTANCES, TO REVISE THE LAW PROHIBITING DISCRIMINATION IN THE TREATMENT OF HANDICAPPED AND DISABLED PERSONS, TO GOVERN MANAGED CARE WITH REGARD TO WORKERS' COMPENSATION, TO EXEMPT COMMERCIAL AIRCRAFT INSURANCE FROM STATE REGULATION, TO REQUIRE ADDITIONAL INFORMATION FROM SURPLUS LINES LICENSEES, TO CLARIFY WHICH SECTIONS OF THE GENERAL STATUTES APPLY TO SURPLUS LINES INSURANCE, TO AUTHORIZE THE SECRETARY OF REVENUE TO PROVIDE THE NORTH CAROLINA SELF-INSURANCE GUARANTY ASSOCIATION WITH INFORMATION ON SELF-INSURERS' PREMIUMS, TO REPEAL THE REQUIREMENT FOR A BIENNIAL REPORT FROM THE DEPARTMENT OF INSURANCE, TO REPEAL THE AGENCY BUSINESS CESSATION LAW, AND TO AUTHORIZE THE COMMISSIONER TO ADOPT RULES RECOGNIZING NEW ANNUITY MORTALITY TABLES.
The General Assembly of North Carolina enacts:

PART I.  HEARINGS AND FAIR AND BEACH PLANS APPEALS.
Section 1.1.  G.S. 58-2-50 reads as rewritten:
"§ 58-2-50.  Examinations, hearings, and investigations.
All examinations, hearings, and investigations provided for by this Chapter may be conducted by the Commissioner personally or by one or more deputies, investigators, actuaries, examiners or employees designated for the purpose. If the Commissioner or any investigator appointed to conduct the investigations is of the opinion that there is evidence to charge any person or persons with a criminal violation of any provision of this Chapter, the Commissioner may arrest with warrant or cause the person or persons to be arrested.  All hearings shall, unless otherwise specially provided, be held in accordance with this Article and Article 3A of Chapter 150B of the General Statutes and at a time and place designated in a written notice given by the Commissioner to the person cited to appear.  The notice shall state the subject of inquiry and the specific charges, if any."
Section 1.2.  G.S. 58-45-50 reads as rewritten:
"§ 58-45-50.  Appeal from acts of Association to Commissioner; appeal from Commissioner to superior court.
Any person or any insurer who may be aggrieved by an act, ruling or decision of the Association other than an act, ruling or decision relating to the cause or amount of a claimed loss, may, within 30 days after the ruling, appeal to the Commissioner. Any hearings held by the Commissioner under the appeal shall be in accordance with rules adopted by the Commissioner: Provided, however, the Commissioner is authorized to appoint a member of the Commissioner's staff as deputy commissioner for the purpose of hearing those appeals and a ruling based upon the hearing shall have the same effect as if heard by the Commissioner. All persons or insureds aggrieved by any order or decision of the Commissioner may appeal as is provided in G.S. 58-2-75.
No later than 20 days before each hearing, the appellant shall file with the Commissioner or the Commissioner's designated hearing officer and shall serve on the appellee a written statement of the appellant's case and any evidence that the appellant intends to offer at the hearing.  No later than five days before the hearing, the appellee shall file with the Commissioner or the designated hearing officer and shall serve on the appellant a written statement of the appellee's case and any evidence that the appellee intends to offer at the hearing.  The procedures governing recordings of hearings and, if necessary, transcripts of recordings, as well as the fees for copies of recordings and transcripts, shall be determined by rules adopted by the Commissioner.  Each party shall, on a date determined by the Commissioner or the designated hearing officer, but not sooner than 15 days after delivery of the completed transcript to the party, submit to the Commissioner or the designated hearing officer and serve on the other party, a proposed order.  The Commissioner or the designated hearing officer shall then issue an order."
Section 1.3.  G.S. 58-46-30 reads as rewritten:
"§ 58-46-30.  Appeals; judicial review.
The association shall provide reasonable means, to be approved by the Commissioner, whereby any person or insurer affected by any act or decision of the administrators of the Plan or underwriting association, other than an act or decision relating to the cause or amount of a claimed loss, may be heard in person or by an authorized representative, before the governing board of the association or a designated committee.  Any person or insurer aggrieved by any decision of the governing board or designated committee, may be appealed to the Commissioner within 30 days after the date of the ruling or decision.  The Commissioner, after a hearing held under rules adopted by the Commissioner, shall issue an order approving or disapproving the act or decision with respect to the matter that is the subject of appeal.  The Commissioner may appoint a member of the Commissioner's staff as deputy commissioner for the purpose of hearing the appeals and a ruling based on the hearing has the same effect as if heard by the Commissioner.  All persons or insurers or their representatives aggrieved by any order or decision of the Commissioner may appeal as provided in G.S. 58-2-75.
No later than 20 days before each hearing, the appellant shall file with the Commissioner or the designated hearing officer and shall serve on the appellee a written statement of the appellant's case and any evidence that the appellant intends to offer at the hearing.  No later than five days before the hearing, the appellee shall file with the Commissioner or the designated hearing officer and shall serve on the appellant a written statement of the appellee's case and any evidence that the appellee intends to offer at the hearing.  The procedures governing recordings of hearings and, if necessary, transcripts of recordings, as well as the fees for copies of recordings and transcripts, shall be determined by rules adopted by the Commissioner.  Each party shall, on a date determined by the Commissioner or the designated hearing officer, but not sooner than 15 days after delivery of the completed transcript to the party, submit to the Commissioner or the designated hearing officer and serve on the other party, a proposed order.  The Commissioner or the designated hearing officer shall then issue an order."

PART II.  CONTINUING CARE RETIREMENT RECEIVERSHIPS.
Section 2.  Article 64 of Chapter 58 of the General Statutes is amended by adding a new section to read:
"§ 58-64-46.  Receiverships; exception for facility beds.
When the Commissioner has been appointed as a receiver under Article 30 of this Chapter for a provider or facility subject to this Article, the Department of Health and Human Services may, notwithstanding any other provision of law, accept and approve the addition of beds for that facility if it appears to the court, upon petition of the Commissioner or the provider, or on the court's own motion, that (i)	the best interests of the facility or (ii) the welfare of persons who have previously contracted with the provider or may contract with the facility may be best served by the addition of adult care home beds."

PART III.  HANDICAPPED PERSONS.
Section 3.1.  G.S. 168-10 reads as rewritten:
"§ 168-10.  Eliminate discrimination in treatment of handicapped and disabled.
Each handicapped person shall have the same consideration as any other person for individual accident and health insurance coverage, and no insurer, service corporation, multiple employer welfare arrangement, or health maintenance organization subject to Chapter 58 of the General Statutes solely on the basis of the person's handicap, shall deny such coverage or benefits.  The availability of coverage or benefits shall not be denied solely because of the handicap; however, any such insurer may charge the appropriate premiums or fees for the risk insured on the same basis and conditions as insurance issued to other persons, in accordance with actuarial and underwriting principles and other coverage provisions prescribed in Chapter 58 of the General Statutes.  "
Section 3.2.  G.S. 168-22(b) reads as rewritten:
"(b)	A family care home shall be deemed a residential use of property for the purposes of determining charges or assessments imposed by political subdivisions or businesses for water, sewer, power, telephone service, cable television, garbage and trash collection, repairs or improvements to roads, streets, and sidewalks, and other services, utilities, and improvements."

PART IV.  WORKERS' COMPENSATION MANAGED CARE.
Section 4.1.  G.S. 58-50-65(a) reads as rewritten:
"(a)	Except as provided in this subsection, nothing in Articles 50 through 55 of this Chapter applies to any liability or workers' compensation insurance policy.  This Article and Articles 65 and 67 of this Chapter and any administrative rules adopted under these Articles relating to preferred providers and utilization review apply to workers' compensation insurance policies and to individual and group self-funded workers' compensation insurance plans.  If there is any conflict between managed care rules adopted by the Commissioner under this Chapter and managed care rules adopted by the Industrial Commission under G.S. 97-25.2, the Industrial Commission's rules govern.  If there is any conflict between managed care provisions of this Chapter and managed care provisions of Chapter 97 of the General Statutes with respect to workers' compensation, the provisions of Chapter 97 govern."
Section 4.2.  G.S. 97-2(21) reads as rewritten:
"(21)	Managed care organization. – The term 'managed care organization' means a preferred provider organization or a health maintenance organization regulated under Chapter 58 of the General Statutes.  'Managed care organization' also means a preferred provider benefit plan of an insurance company, hospital, or medical service corporation in which utilization review or quality management programs are used to manage the provision of health care services and benefits under this Chapter."

PART V.  COMMERCIAL AIRCRAFT INSURANCE.
Section 5.1.  G.S. 58-7-15(19) reads as rewritten:
"(19)	'Motor vehicle insurance,' meaning insurance against loss of or damage resulting from any cause to motor vehicles or and their equipment, and against legal liability of the insured for loss or damage to another's property resulting from the ownership, maintenance or use of motor vehicles or and against loss, damage or expense incident to a claim of such liability."
Section 5.2.  G.S. 58-41-10(a) reads as rewritten:
"(a)	Except as otherwise provided, this Article applies to all kinds of insurance authorized by G.S. 58-7-15(4) through (14) and G.S. 58-7-15(18) through (22), and to all insurance companies licensed by the Commissioner to write those kinds of insurance. This Article does not apply to insurance written under Articles 21, 36, 37, 45 or 46 of this Chapter; insurance written for residential risks in conjunction with insurance written under Article 36 of this Chapter; to marine insurance as defined in G.S. 58-40-15(3); to personal inland marine insurance; to commercial aircraft insurance; to policies issued in this State covering risks with multistate locations, except with respect to coverages applicable to locations within this State; to any town or county farmers mutual fire insurance association restricting its operations to not more than six adjacent counties in this State; nor to domestic insurance companies, associations, orders, or fraternal benefit societies doing business in this State on the assessment plan."
Section 5.3.  G.S. 58-21-10(8) reads as rewritten:
"(8)	'Surplus lines insurance' means any insurance in this State of risks resident, located, or to be performed in this State, permitted to be placed through a surplus lines licensee with a nonadmitted insurer eligible to accept such insurance, other than reinsurance, commercial aircraft insurance, wet marine and transportation insurance, insurance independently procured pursuant to G.S. 58-28-5, life and accident or health insurance, and annuities."
Section 5.4.  G.S. 58-28-5(a) reads as rewritten:
"(a)	Except as otherwise provided in this section, it is unlawful for any company to enter into a contract of insurance as an insurer or to transact insurance business in this State as set forth in G.S. 58-28-10, without a license issued by the Commissioner. This section does not apply to the following acts or transactions:
(1)	The procuring of a policy of insurance upon a risk within this State where the applicant is unable to procure coverage in the open market with admitted companies and is otherwise in compliance with Article 21 of this Chapter.
(2)	Contracts of reinsurance; but not including assumption reinsurance transactions, whereby the reinsuring company succeeds to all of the liabilities of and supplants the ceding company on the insurance contracts that are the subject of the transaction, unless prior approval has been obtained from the Commissioner.
(3)	Transactions in this State involving a policy lawfully solicited, written and delivered outside of this State covering only subjects of insurance not resident, located or expressly to be performed in this State at the time of issuance, and which transactions are subsequent to the issuance of such policy.
(4)	Transactions in this State involving group life insurance, group annuities, or group, blanket, or franchise accident and health insurance where the master policy for the insurance was lawfully issued and delivered in a state in which the company was authorized to transact business.
(5)	Transactions in this State involving all policies of insurance issued before July 1, 1967.
(6)	The procuring of contracts of insurance issued to a nuclear insured.  As used in this subdivision, 'nuclear insured' means a public utility procuring insurance against radioactive contamination and other risks of direct physical loss at a nuclear electric generating plant.
(7)	Insurance independently procured, as specified in subsection (b) of this section.
(8)	Insurance on vessels or craft, their cargoes, marine builders' risks, marine protection and indemnity, or other risks commonly insured under marine insurance policies, as distinguished from inland marine insurance policies.
(9)	Transactions in this State involving commercial aircraft insurance, meaning insurance against (i) loss of or damage resulting from any cause to commercial aircraft and its equipment, (ii) legal liability of the insured for loss or damage to another person's property resulting from the ownership, maintenance, or use of commercial aircraft, and (iii) loss, damage, or expense incident to a liability claim."
Section 5.5.  G.S. 58-1-5 reads as rewritten:
"§ 58-1-5.  Definitions.
In this Chapter, unless the context clearly requires otherwise:
(1)	'Alien company' means a company incorporated or organized under the laws of any jurisdiction outside of the United States.
(1a)	'Commercial aircraft' means aircraft used in domestic, flag, supplemental, commuter, or on-demand operations, as defined in Federal Aviation Administration Regulations, 14 C.F.R. § 119.3, as amended.
(2)	'Commissioner' means the Commissioner of Insurance of North Carolina or an authorized designee of the Commissioner.
(3)	'Company' or 'insurance company' or 'insurer' includes any corporation, association, partnership, society, order, individual or aggregation of individuals engaging or proposing or attempting to engage as principals in any kind of insurance business, including the exchanging of reciprocal or interinsurance contracts between individuals, partnerships and corporations. 'Company' or 'insurance company' or 'insurer' does not mean the State of North Carolina or any county, city, or other political subdivision of the State of North Carolina.
(4)	'Department' means the Department of Insurance of North Carolina.
(5)	'Domestic company' means a company incorporated or organized under the laws of this State.
(6)	'Foreign company' means a company incorporated or organized under the laws of the United States or of any jurisdiction within the United States other than this State.
(7)	'NAIC' means the National Association of Insurance Commissioners.
	"(9)	'Person' means an individual, partnership, firm, association, corporation, joint-stock company, trust, any similar entity, or any combination of the foregoing acting in concert. "Person"does not mean the State of North Carolina or any county, city, or other political subdivision of the State of North Carolina.
(10)	The singular form includes the plural, and the masculine form includes the feminine wherever appropriate."

PART VI.  SURPLUS LINES FILINGS.
Section 6.1.  G.S. 58-21-35 reads as rewritten:
"§ 58-21-35.  Duty to file reports and retain affidavit.
(a)	Within 30 days after the placing of any surplus lines insurance, the surplus lines licensee shall file with the Commissioner a
	report in a format prescribed by the Commissioner regarding the insurance and including the following information:
(1)	The name of the insured.
(2)	The identity of the insurer or insurers.
(3)	A description of the subject and location of the risk.
(4)	The amount of premium charged for the insurance.
	(5)	The amount of premium tax for the insurance.
(6)	The policy period.
(7)	The policy number.
(8)	The name, address, telephone number, facsimile telephone number, and electronic mail address of the licensee, as applicable.
(9)	Any other relevant information the Commissioner may reasonably require.
	(b)	The licensee shall complete and retain an affidavit as to the efforts to place the coverage with admitted insurers and the results of the efforts, in accordance with G.S. 58-21-15. The report and affidavit required by this section and the quarterly report required by G.S. 58-21-80 shall be completed on a standardized form or forms prescribed by the Commissioner and are not public records under G.S. 132-1 or G.S. 58-2-100."
Section 6.2.  Article 21 of Chapter 58 of the General Statutes is amended by adding a new section to read:
"§ 58-21-2.  Relationship to other insurance laws.
Unless surplus lines insurance, surplus lines licensees, or nonadmitted insurers are specifically referenced in a particular section of this Chapter, no sections contained in Articles of this Chapter other than this Article apply to surplus lines insurance, surplus lines licensees, or nonadmitted insurers."

PART VII.  WORKERS' COMPENSATION SELF-INSURANCE.
Section 7.  G.S. 105-259(b) is amended by adding a new subdivision to read:
"(16a)	To provide the North Carolina Self-Insurance Guaranty Association information on self-insurers' premiums as determined under G.S. 105-228.5(b), (b1), and (c) for the purpose of collecting the assessments authorized in G.S. 97-133(a)."

PART VIII.  REPEAL REQUIREMENT OF BIENNIAL REPORT.
Section 8.  G.S. 58-2-120 reads as rewritten:
"§ 58-2-120. Reports of Commissioner to the Governor and General Assembly.
The Commissioner shall, from time to time, report to the Governor and the General Assembly any change or changes that in the Commissioner's opinion should be made in the laws relating to insurance and other subjects pertaining to the Department."

PART IX.  REPEAL THE AGENCY BUSINESS CESSATION LAW.
Section 9.  G.S. 58-41-35 is repealed.
Section 9.1.  G.S. 58-41-40(a) reads as rewritten:
"(a)	There is no liability on the part of and no cause of action for defamation or invasion of privacy arises against any insurer or its authorized representatives, agents, or employees, or any licensed insurance agent or broker, for any communication or statement made, unless shown to have been made in bad faith with malice, in any of the following:
(1)	A written notice of cancellation under G.S. 58-41-15 or of nonrenewal under G.S. 58-41-20, specifying the reasons for cancellation.
(2)	Communications providing information pertaining to the cancellation or nonrenewal.
(3)	Evidence submitted at any court proceeding, administrative hearing, or informal inquiry in which the cancellation or nonrenewal is an issue."

PART X.  MORTALITY TABLE AND RESERVES UPDATE.
Section 10.  G.S. 58-58-50(k) reads as rewritten:
"(k)	The Commissioner shall adopt rules containing the minimum standards applicable to the valuation of health plans.  The Commissioner may also adopt rules for the purpose of recognizing new annuity mortality tables for use in determining reserve liabilities for annuities and may adopt rules that govern minimum valuation standards for reserves of life insurance companies.  In adopting these rules, the Commissioner may consider model laws and regulations promulgated and amended from time to time by the NAIC."

PART XI.  EFFECT OF HEADINGS.
Section 11.  The headings to the parts of this act are a convenience to the reader and are for reference only.  The headings do not expand, limit, or define the text of this act.

PART XII.  EFFECTIVE DATE.
Section 12.  Sections 2 through 11 of this act become effective October 1, 1999.  The remainder of this act is effective when this act becomes law, but Sections 1.1, 1.2, and 1.3 of this act shall not apply to appeals pending on the date this act becomes law.