Repealed or Renumbered

Provisions of this title relative to a particular kind of insurance or a particular type of insurer or to a particular matter prevail over provisions relating to insurance in general or insurers in general or to a particular matter in general.

Repealed or Renumbered

A person determined by the director, following an appropriate hearing as provided in Section 21.06.170 - 21.06.230, to have violated a provision of this title or a regulation adopted under it, for which violation a greater penalty is not provided in this title, is subject to a civil penalty of not more than $2,500.

In this title, unless the context requires otherwise,

(1) 'admitted insurer' means an authorized insurer;

(2) 'agent' means a person appointed by an insurer to solicit applications for insurance or annuities on its behalf, and if authorized to do so, to effectuate and countersign insurance contracts, except life or health insurance or annuities, and to collect premiums on insurance or annuities;

(3) 'alien insurer' means an insurer formed under the laws of a country other than the United States of America, its states, districts, territories, and commonwealths;

(4) 'assumption reinsurance' means a form of reinsurance that includes the transfer of all contractual obligations to the assuming insurer with no recourse to the ceding insurer;

(5) 'attorney-in-fact' means a person designated and appointed by the subscribers of a reciprocal insurer to act for and bind the subscribers in transactions relating to or arising out of the operations of a reciprocal insurer, subject to the limitations that may be lawfully provided;

(6) 'authorized insurer' means an insurer authorized by a certificate of authority issued by the director to transact insurance in this state;

(7) 'broker' means a person who is not an agent of the insurer and who, on behalf of the insured, for compensation as an independent contractor by commission or fee, solicits, negotiates, or procures insurance or reinsurance or the renewal or continuance of insurance or reinsurance; or in any manner aids in the solicitation, negotiation, procurement, renewal, or continuance of insurance or reinsurance, for insureds or prospective insureds not including the broker;

(8) 'certified financial statement' means a financial statement upon which an independent certified public accountant, or an accountant holding a substantially equivalent designation as determined by the director, renders or disclaims an opinion after performance of an audit;

(9) 'commissioner' means the commissioner of commerce, community, and economic development;

(10) 'court' means superior court;

(11) 'director' means the director of the division of insurance;

(12) 'division' means the division of insurance, Department of Commerce, Community, and Economic Development;

(13) 'domestic insurer' means an insurer formed under the laws of this state;

(14) 'evergreen clause' means a contract clause that provides that the contract is automatically renewed unless notice to the contrary is given by one of the parties to the contract;

(15) 'examiner' means an individual or firm that has been authorized by the director to conduct an examination under this title;

(16) 'facultative reinsurance' means a contract of reinsurance for individual risks where the insurer retains the ability to accept or reject each risk offered by the ceding company;

(17) 'firm' means an organization of two or more licensees acting in association with each other, either in a partnership, corporation, or otherwise, or an organization in which a single licensee has less than 50 percent ownership interest in the organization;

(18) 'foreign insurer' means an insurer formed under the laws of a jurisdiction other than this state and includes an alien insurer;

(19) 'impaired' or 'impairment' means that

(A) an insurer's policyholder surplus is greater than zero but less than that required by Section 21.09.070 for the authority to transact the kinds of insurance being transacted; or

(B) an insurer is being operated in a manner that has caused or might cause irreparable loss and injury to the insurer or to the public;

(20) 'independent adjuster' means a person who, for compensation as an independent contractor or as an employee of an independent contractor, for fee or commission, investigates and adjusts losses or claims arising under insurance contracts on behalf of an insurer;

(21) 'independently procured insurance' means insurance procured directly from a nonadmitted insurer directly by an insured, but does not include insurance lawfully procured through a surplus lines broker under Section 21.34;

(22) 'industrial life insurance' means that form of life insurance written under policies with a face amount of $1,000 or less, with the words 'industrial policy' imprinted on the face as part of the descriptive matter, and under which premiums are payable monthly or more often;

(23) 'insolvent' or 'insolvency' means that an insurer's policyholder surplus is less than or equal to zero;

(24) 'insurance' means a contract whereby one undertakes to indemnify another or pay or provide a specified or determinable amount or benefit upon determinable contingencies;

(25) 'insurance producer' has the meaning given in Section 21.27.900 ;

(26) 'insurer' includes a person engaged as indemnitor, surety, or contractor in the business of entering into contracts of insurance or of annuity;

(27) 'licensee' means a person or firm licensed as provided in Section 21.27;

(28) 'managing general agent' means a person, firm, or corporation that

(A) has authority to exercise general supervision over the business, or any part of the business, of one or more admitted insurers; and

(B) performs administrative functions normally performed by the insurer including claims administration and payment, marketing administration, agent appointment, premium accounting, premium billing, coverage verification, final underwriting authority, or certificate issuance;

(29) 'medical care' means amounts paid for

(A) diagnosis, care, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body;

(B) transportation primarily for and essential to medical care described in (A) of this paragraph; and

(C) insurance covering medical care described in (A) and (B) of this paragraph.

(30) 'nonadmitted insurer' means an unauthorized insurer;

(31) 'person' has the meaning given in Section 01.10.060 and includes an insurer, Lloyd's, fraternal benefit society, medical service, or hospital service plan as defined in Section 21.87, reciprocal or interinsurance exchange, syndicate, and any other legal entity engaged in the business of transacting insurance;

(32) 'policy' means the written contract of or written agreement for or effecting insurance, by whatever name called, and includes all clauses, riders, endorsements, and papers attached to it and a part of it; for a group, trust, association, or similar entity, 'policy' also means a certificate or other evidence of insurance that establishes the written contract of or written agreement for or effecting insurance for an insured or other beneficiary of the entity;

(33) 'policyholder surplus' means

(A) for a stock insurer, the sum of its capital, as represented by the aggregate par value to its outstanding capital stock, and its surplus, if any;

(B) for a mutual insurer, its surplus, both basic guaranteed and additional, if any;

(C) for an insurer other than a stock or mutual insurer, the net worth of the insurer, calculated as its recorded assets less its liabilities, as determined by the accounting criteria set out in this title;

(34) 'premium' means the consideration for insurance, by whatever name called, and by whatever method paid or collected, including an assessment, or membership, policy, survey, inspection, service or similar fee or charge made in consideration for an insurance contract;

(35) 'reinsurance' means an insurance transaction by which the assuming insurer agrees to indemnify the ceding insurer in whole or in part against liability or losses that the ceding insurer might incur under a separate contract of insurance with its insured;

(36) 'reinsurance intermediary' means a person who acts as a producer in soliciting, negotiating, or procuring the making of a reinsurance contract or binder on behalf of a ceding admitted insurer or acts as a producer in accepting a reinsurance contract or binder on behalf of an assuming admitted insurer;

(37) 'reinsurance intermediary broker' means a person who solicits, negotiates, or places reinsurance cessions or retrocessions on behalf of a ceding admitted insurer without the authority or power to bind reinsurance on behalf of the insurer;

(38) 'reinsurance intermediary manager' means a person including an insurer who has authority to bind or manage all or part of the assumed reinsurance business of an admitted reinsurer, including the management of a separate division, department, or underwriting office, and who acts as an agent for the reinsurer;

(39) 'state' means a state, District of Columbia, territory, commonwealth, or possession of the United States of America;

(40) 'surplus lines broker' means a person licensed under Section 21.27 to place insurance in this state or relative to a subject resident, located, or to be performed in this state with eligible surplus lines insurers under Section 21.34;

(41) 'surplus lines insurance' means any insurance in this state or relative to a subject resident, located, or to be performed in this state that is permitted under Section 21.34 to be placed through a surplus lines broker licensed under Section 21.27 with nonadmitted insurers eligible to accept insurance other than reinsurance, wet marine and transportation insurance, insurance independently procured, life insurance, and an annuity contract;

(42) 'third-party administrator' means a person who for residents of this state, or for residents of another jurisdiction from a place of business in this state, performs administrative functions including claims administration and payment, marketing administrative functions, premium accounting, premium billing, coverage verification, underwriting authority, or certificate issuance in regard to life insurance, health insurance, or annuities;

(43) 'transact' with respect to insurance includes

(A) solicitation and inducement;

(B) preliminary negotiations;

(C) effectuation of a contract of insurance;

(D) transaction of matters subsequent to effectuation of the contract of insurance and arising out of it;

(44) 'unauthorized insurer' means an insurer not authorized to transact insurance in this state.