[Rev. 1/16/2013 11:48:07 AM--2012R2]
NRS 679B.020 Appointment; restrictions on other employment and certain political activities.
NRS 679B.030 Qualifications.
NRS 679B.050 Official seal.
NRS 679B.060 Office space.
NRS 679B.080 Designation of acting Commissioner; powers and duties of deputies; restrictions on other employment of deputies.
NRS 679B.090 Employment of assistants and examiners; contracts for certain assistance.
NRS 679B.100 Prohibited interests of Commissioner, deputy or employee; penalty.
NRS 679B.110 Delegation of powers.
NRS 679B.115 Limitation on civil liability.
NRS 679B.120 Authority of Commissioner: General powers and duties.
NRS 679B.122 Authority of Commissioner: Cooperative or coordination agreements; confidential documents.
NRS 679B.125 Observation of conduct of persons in insurance business; regulations.
NRS 679B.127 Counseling elderly persons concerning health insurance; regulations.
NRS 679B.130 Regulations: Adoption; penalties for violation.
NRS 679B.133 Regulations: Requirements regarding use of identification cards and devices to process claims for prescription drugs and devices.
NRS 679B.135 Regulations: Protections to purchasers, prospective purchasers, holders and former holders of policies.
NRS 679B.136 Regulations: Use of electronic signatures, records and payments; electronic filing of forms and payment of fees.
NRS 679B.137 Regulations: Method for maintaining records.
NRS 679B.138 Regulations: Use of uniform claim forms and billing codes; transfer of electronic data.
NRS 679B.139 Regulations: Plans for providing welfare benefits to employees of more than one employer.
NRS 679B.140 Orders and notices.
NRS 679B.142 Orders prohibiting insurer from transacting insurance; Commissioner to deliver to Secretary of State; duty of Secretary of State upon receipt.
NRS 679B.144 Commissioner required to collect information regarding closed claims for medical malpractice; submission to Legislature; regulations.
NRS 679B.145 Publication, maintenance and distribution of guide to rates for policies of insurance for motor vehicles.
NRS 679B.150 Measures to enhance public understanding of coverages and to encourage competition; standards for policies; criteria to determine suitability of contracts and sales practices.
NRS 679B.152 Review of fees for medical or dental care determined to be usual and customary; plans limiting selection of dentist.
NRS 679B.159 Report of violation to Commissioner; confidentiality of report.
NRS 679B.160 Advisory councils.
NRS 679B.170 Private ombudsmen.
NRS 679B.180 Enforcement.
NRS 679B.185 Administrative fine for willfully engaging in unauthorized transaction of insurance: Limitation; enforcement.
NRS 679B.187 Person who invests or handles money or assets of insurer designated fiduciary; penalty for engaging in prohibited conduct.
NRS 679B.190 Maintenance, inspection and destruction of records; confidentiality and use of documents and other information.
NRS 679B.200 Evidentiary effect of Commissioner’s certificates and certified copies of documents.
NRS 679B.220 Interstate and international cooperation.
NRS 679B.225 Inspection of insurance policies.
NRS 679B.227 Statute of limitations for commencing proceedings to collect premium tax.
NRS 679B.228 Fee for returned check or other dishonored payment.
NRS 679B.230 Examination of insurers.
NRS 679B.240 Examination of holding companies, subsidiaries, agents, promoters, independent review organizations and others.
NRS 679B.250 Conduct of examination; access to records; corrections; penalty.
NRS 679B.260 Appraisal of asset.
NRS 679B.270 Report of examination: Contents; evidentiary effect in certain proceedings.
NRS 679B.280 Report of examination: Right of examinee to review and respond to report; Commissioner to issue order regarding action to be taken on report.
NRS 679B.282 Report of examination: Hearing; filing; distribution.
NRS 679B.285 Report of examination: Confidentiality.
NRS 679B.287 Limitations on actions and liability for communicating or delivering information or data pursuant to examination; Commissioner, representatives and examiners entitled to attorney’s fees and costs in certain tort actions.
NRS 679B.290 Expense of examination; billing for examination; regulations.
NRS 679B.300 Insurance Examination Account.
INSURANCE RECOVERY ACCOUNT
NRS 679B.305 Creation; deposits; use; regulations; limit of liability.
NRS 679B.310 Administrative procedures; hearings in general.
NRS 679B.320 Notice of hearing.
NRS 679B.330 Location; presiding officer; evidence; parties; record of proceedings and evidence.
NRS 679B.340 Witnesses and evidence; penalties.
NRS 679B.350 Testimony compelled; immunity from prosecution.
NRS 679B.360 Order on hearing.
NRS 679B.370 Appeal from Commissioner.
NRS 679B.380 Financing of administration.
STABILIZATION OF INSURANCE COSTS
NRS 679B.400 Legislative findings and declarations; purposes.
NRS 679B.410 Duties of Commissioner.
NRS 679B.420 Employment of technical and professional consultants.
NRS 679B.430 Commissioner may issue orders for compliance with provisions; regulation of recording and reporting of information by insurers; insurer to report information and pay fee.
NRS 679B.440 Contents of reports.
NRS 679B.450 Fee for administration and enforcement; cost of report; schedule of fees; Stabilization of Insurance Costs Account.
NRS 679B.460 Penalties for violation of or noncompliance with provisions or regulations.
PROTECTIONS FOR CONSUMERS OF HEALTH CARE
NRS 679B.510 Definitions.
NRS 679B.520 “Health care plan” defined.
NRS 679B.530 “Insured” defined.
NRS 679B.540 “Insurer” defined.
NRS 679B.550 Duties of Division.
NRS 679B.560 Insurer required to provide information to insured.
NRS 679B.600 Definitions.
NRS 679B.610 “Fraud Control Unit” defined.
NRS 679B.620 “Insurance fraud” defined.
NRS 679B.630 Program to investigate acts or practices of fraud.
NRS 679B.640 Commissioner required to investigate fraudulent claims for benefits.
NRS 679B.650 Investigative authority of Commissioner.
NRS 679B.660 Cooperation between Commissioner, Attorney General and investigative and law enforcement agencies.
NRS 679B.670 Liability for disclosure of information on fraudulent claim or suspicious fire.
NRS 679B.680 Effect of certain powers and duties of Attorney General and Fraud Control Unit on jurisdiction of Commissioner.
NRS 679B.690 Confidentiality of records and other information related to investigation by Attorney General and Fraud Control Unit.
NRS 679B.700 Special Investigative Account.
1. The chief officer of the Division is the Commissioner appointed as provided in NRS 232.820.
2. The Commissioner shall not:
(a) Except as otherwise provided in NRS 284.143, engage in any other occupation, business or activity that is in any way inconsistent with the performance of his or her duties as Commissioner;
(b) Hold any other public office;
(c) Directly or indirectly solicit or receive, or be in any manner concerned with soliciting or receiving, any assessment, subscription, contribution or service, whether voluntary or involuntary, for any political purpose whatever, from any person within or without the State; or
(d) Act as an officer or manager for any candidate, political party or committee organized to promote the candidacy or any person for any public office.
1. The Commissioner shall have had at least 2 years’ responsible experience in the field of insurance, including, but not limited to, one or more of the following endeavors: Administration, sales, law, counseling and education.
2. The Commissioner shall not be a stockholder in or directly or indirectly connected with the management or affairs of any insurance company or insurance brokerage or agency.
(Added to NRS by 1971, 1931)
NRS 679B.060 Office space. The Buildings and Grounds Section of the State Public Works Division of the Department of Administration shall furnish the Division with suitable office space for the performance of its duties.
1. The Director of the Department of Business and Industry shall designate an acting Commissioner when the Office of Commissioner is vacant or when the Commissioner is unable to perform his or her duties because of mental or physical disability.
2. The Commissioner shall designate one of his or her deputies to serve as acting Commissioner in the Commissioner’s absence.
3. The deputies have such powers and duties as the Commissioner delegates and assigns to them.
4. Except as otherwise provided in NRS 284.143, the deputies shall devote their full time to the Division.
1. The Commissioner may employ such other technical, actuarial, rating, clerical and other assistants and examiners as may reasonably be required for execution of the duties of the Commissioner, each of whom must be in the classified service of the State.
2. The Commissioner may contract for and procure services of examiners and other or additional specialized technical or professional assistance, as independent contractors or for a fee, as may reasonably be required. None of the persons providing those services or assistance on contract or for a fee may be in the classified service of the State.
3. The Commissioner may contract with a person outside the Division for administering examinations, processing applications for licenses and collecting fees.
4. The Commissioner may adopt regulations to carry out the provisions of subsections 2 and 3.
(Added to NRS by 1971, 1562; A 1975, 352; 1983, 1126; 1985, 447, 1367; 2001, 2180)
1. The Commissioner, his or her deputy or any examiner, assistant or employee of the Division shall not be connected with the management or be a stockholder, or be otherwise financially interested in any insurer, insurance holding company or its parent, subsidiaries or affiliates, insurance agency or broker, insurance trade association, premium finance company, adjuster or other licensee under this Code, or be pecuniarily interested in any insurance transaction except as a policyholder or claimant under a policy, except that as to matters wherein a conflict of interests does not exist on the part of any such person, the Commissioner may employ or retain from time to time insurance actuaries, examiners, accountants, attorneys or other technicians who are independently practicing their professions even though from time to time similarly employed or retained by insurers or others.
2. Subsection 1 does not prohibit:
(a) Receipt by any such person of fully vested commissions or fully vested retirement benefits to which he or she is entitled by reason of services performed before becoming Commissioner or before employment by the Commissioner;
(b) Investment in shares of regulated diversified investment companies; or
(c) Mortgage loans made under customary terms and in the ordinary course of business.
3. Any person knowingly violating this section is guilty of a misdemeanor.
1. The Commissioner may delegate to his or her deputy, examiner or an employee of the Division the exercise or discharge in the Commissioner’s name of any power, duty or function, whether ministerial, discretionary or of whatever character, vested in or imposed upon the Commissioner.
2. The official act of any such person acting in the Commissioner’s name and by his or her authority shall be deemed an official act of the Commissioner.
1. The Commissioner and the employees of the Division, in the absence of fraud or bad faith, are not subject to civil liability for publishing any report or bulletin related to the official activities of the Commissioner or the Division.
2. This section does not abrogate or modify any privilege or immunity which applies to the Commissioner or the employees of the Division.
1. Organize and manage the Division, and direct and supervise all its activities;
2. Execute the duties imposed upon him or her by this Code;
3. Enforce the provisions of this Code;
4. Have the powers and authority expressly conferred upon him or her by or reasonably implied from the provisions of this Code;
5. Conduct such examinations and investigations of insurance matters, in addition to examinations and investigations expressly authorized, as he or she may deem proper upon reasonable and probable cause to determine whether any person has violated any provision of this Code or to secure information useful in the lawful enforcement or administration of any such provision; and
6. Have such additional powers and duties as may be provided by other laws of this State.
1. In addition to the authority conferred upon him or her pursuant to NRS 679B.120, the Commissioner may:
(a) Enter into and comply with any cooperative or coordination agreement with any governmental entity within or outside this state relating to the regulation and administration of insurance and persons who are materially involved in the business of insurance;
(b) Share any document, material or other information, including any document, material or information that is confidential or privileged, with any state, federal or international regulatory, law enforcement or legislative agency, and the National Association of Insurance Commissioners and any of its affiliates or subsidiaries, if the recipient of the document, material or other information agrees:
(1) To ensure that the document, material or other information remains confidential and privileged; and
(2) To submit to the jurisdiction of the courts of this state if the recipient violates a provision of subparagraph (1); and
(c) Receive any document, material or other information from any agency, association, affiliate or subsidiary specified in paragraph (b). The Commissioner shall ensure that any document, material or information received pursuant to this paragraph remains confidential if the document, material or information is provided to the Commissioner with a notice or the understanding that it is confidential or privileged under the laws of the jurisdiction from which it is submitted.
2. The sharing or receipt of any document, material or other information by the Commissioner pursuant to this section does not waive any applicable privilege or claim of confidentiality in the document, material or other information.
(Added to NRS by 2003, 3275)
NRS 679B.125 Observation of conduct of persons in insurance business; regulations. The Commissioner may observe the conduct of each authorized insurer and other persons who have a direct material involvement with the insurance business to ensure that:
1. An unqualified, disqualified or unsuitable person is not involved in insurance; and
2. The insurance business is not conducted in an unsuitable manner.
(Added to NRS by 1991, 807)
1. The Commissioner may participate in a program which provides counseling to elderly persons concerning health insurance, including a program established pursuant to 42 U.S.C. § 1395b-4.
2. The Commissioner may adopt regulations necessary to carry out the provisions of this section.
(Added to NRS by 1993, 2381)
1. The Commissioner may adopt reasonable regulations:
(b) As required to ensure compliance by the Commissioner with any federal law or regulation relating to insurance.
2. A person who willfully violates any regulation of the Commissioner is subject to such suspension or revocation of a certificate of authority or license, or administrative fine in lieu of such suspension or revocation, as may be applicable under this Code or chapter 616A, 616B, 616C, 616D or 617 of NRS for violation of the provision to which the regulation relates. No penalty applies to any act done or omitted in good faith in conformity with any such regulation, notwithstanding that the regulation may, after the act or omission, be amended, rescinded or determined by a judicial or other authority to be invalid for any reason.
1. If a health care plan that provides coverage for prescription drugs or devices issues a single identification card or other device to an insured that contains information solely needed to process a claim for a prescription drug or device, the card or other device must conform to the requirements of the National Council for Prescription Drug Programs set forth in the NCPDP Pharmacy ID Card Implementation Guide that are consistent with applicable regulations adopted pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as they may be amended from time to time, or must contain at least the following elements:
(a) The name or logo of the administrator issuing the card or device.
(b) The insured’s identification number, which must be displayed on the front side of the card or device.
(c) The name and address of the administrator to which prescription claims that are not processed electronically or correspondence should be sent.
(d) The telephone number that providers may call for assistance concerning pharmacy benefits.
(e) Complete information concerning routing of electronic transactions, including, without limitation, the international identification number and, if required by the administrator to process the claim, the processing control number and group number.
Ê The information on the card or device must be arranged in a manner that corresponds both in content and form to the content and form required by the plan to process the claim.
2. The Commissioner shall adopt such regulations as are necessary to carry out the provisions of this section.
3. As used in this section:
(a) “Administrator” has the meaning ascribed to it in NRS 683A.025, and includes a pharmacy benefits manager.
(b) “Health care plan” has the meaning ascribed to it in NRS 679B.520.
(Added to NRS by 2001, 838)
NRS 679B.135 Regulations: Protections to purchasers, prospective purchasers, holders and former holders of policies. The Commissioner may adopt regulations which provide in substance the same protections to purchasers, prospective purchasers, holders and former holders of policies and other evidence of insurance as are provided in the Insurance Information and Privacy Protection Model Act, as amended in December 1980, of the National Association of Insurance Commissioners.
(Added to NRS by 1981, 1860)
1. The Commissioner shall adopt regulations governing:
(a) The use of electronic signatures, and the acceptance and transmission of electronic records and payments, including transactions involving claims and other transactions relating to insurance; and
(b) The electronic filing of forms and payment of fees, and the storage and reproduction of records, filed with the Division.
2. As used in this section:
(a) “Electronic” means relating to technology having electrical, digital, magnetic, wireless, optical, electromagnetic or similar capabilities.
(b) “Electronic record” means a record created, generated, sent, communicated, received or stored by electronic means.
(c) “Electronic signature” means an electronic sound, symbol or process attached to or logically associated with a record and executed or adopted by a person with the intent to sign the record.
(d) “Record” means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in perceivable form.
(e) “Transaction” means an action or set of actions occurring between two or more persons relating to the transaction of business, commercial or governmental affairs.
NRS 679B.137 Regulations: Method for maintaining records. The Commissioner may adopt regulations which prescribe the method for maintaining the records of insurers and the period for which the records must be maintained.
(Added to NRS by 1985, 1063)
1. The Commissioner shall adopt regulations which require the use of uniform claim forms and billing codes and the ability to make compatible electronic data transfers for all insurers and administrators authorized to conduct business in this state relating to a health care plan or health insurance or providing or arranging for the provision of health care services, including, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation, a health maintenance organization, a plan for dental care and a prepaid limited health service organization. The regulations must include, without limitation, a uniform billing format to be used for the submission of claims to such insurers and administrators.
2. As used in this section:
(a) “Administrator” has the meaning ascribed to it in NRS 683A.025.
(b) “Health care plan” means a policy, contract, certificate or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.
1. The Commissioner may adopt regulations governing plans for providing welfare benefits to employees of more than one employer. The regulations must provide standards requiring the maintenance of specified levels of reserves and specified levels of contributions which any such plan, or any trust established under such a plan, must meet. If a plan does not meet the standards, no benefits may be paid under the plan.
2. The Commissioner may conduct an examination of any insurer which administers a plan for providing welfare benefits to employees of more than one employer to determine whether the insurer is complying with the Commissioner’s regulations. The cost of the examination must be borne by the insurer in the manner provided in NRS 679B.290. If the Commissioner determines that the insurer is not complying with the Commissioner’s regulations, the Commissioner shall require the insurer not to pay benefits under the plan.
3. As used in this section, the term “plan for providing welfare benefits for employees of more than one employer” is intended to be equivalent to the term “employee welfare benefit plan which is a multiple employer welfare arrangement” as used in federal statutes and regulations.
(Added to NRS by 1985, 606)
1. Orders and notices of the Commissioner are effective only when in writing signed by the Commissioner or by the authority of the Commissioner.
2. Except as otherwise expressly provided by law as to particular orders, every order of the Commissioner must state its effective date, and concisely state:
(a) Its intent or purpose;
(b) The grounds on which it is based; and
(c) The provisions of this Code pursuant to which action is taken or proposed to be taken but failure to so designate a particular provision does not deprive the Commissioner of the right to rely thereon.
3. Except as otherwise provided as to particular procedures, an order or notice may be given by delivery to the person to be ordered or notified, or by mailing it, postage prepaid, addressed to that person at his or her principal place of business or residence as last of record in the Division. The order or notice shall be deemed to have been given when deposited with the United States Postal Service, and of which the affidavit of the person who so mailed the order or notice is prima facie evidence.
1. The Commissioner shall deliver to the Secretary of State a copy of an order of the Commissioner or of the district court prohibiting an insurer from transacting insurance in this state as a corporation, limited-liability company, limited partnership or limited-liability partnership.
2. Upon receiving the order, the Secretary of State shall nullify the charter of the corporation or limited-liability company or the certificate of the limited partnership or limited-liability partnership.
3. The Secretary of State shall not accept for filing a document with the same name as a corporation, limited-liability company, limited partnership or limited-liability partnership whose charter or certificate has been nullified.
(Added to NRS by 1997, 3016)
1. The Commissioner shall collect and maintain the information provided by insurers pursuant to NRS 690B.260 regarding each closed claim for medical malpractice filed against a person who is covered by a policy of insurance for medical malpractice in this state, including, without limitation:
(a) The cause of the loss;
(b) A description of the injury for which the claim was filed;
(c) The sex of the injured person;
(d) The names and number of defendants in each claim;
(e) The type of coverage provided;
(f) The amount of the initial, highest and last reserves of an insurer for each claim before final resolution of the claim by settlement or trial;
(g) The disposition of each claim;
(h) The amount of money awarded through settlement or by verdict;
(i) The sum of money paid to each claimant and the source of that sum;
(j) Any sum of money allocated to expenses for the adjustment of losses; and
(k) Any other information the Commissioner determines to be necessary or appropriate.
2. The Commissioner shall submit with the report to the Legislature required pursuant to NRS 679B.410 a summary of the information collected pursuant to this section.
3. The Commissioner shall adopt regulations necessary to carry out the provisions of this section.
4. As used in this section, “policy of insurance for medical malpractice” means a policy that provides coverage for any medical professional liability of the insured under the policy.
1. Publish a guide to rates for policies of insurance for motor vehicles which contains:
(a) An explanation of the various types of coverage available.
(b) A list of all insurers which offer insurance for motor vehicles in Nevada.
(c) Comparisons of the cost for each type of insurance when purchased from the five insurers who offer it at the highest price and the five insurers who offer it at the lowest price, using one or more hypothetical examples developed by the Commissioner.
(d) Any other information which the Commissioner deems appropriate and useful to the public.
2. Maintain the guide by republishing it with revised information at least once each year.
3. Distribute the guide and the information contained in the guide in any manner the Commissioner deems appropriate.
(Added to NRS by 1989, 577)
1. The Commissioner may:
(a) Take measures to enhance the public understanding of insurance coverages purchased by consumers and encourage price competition among insurers and a public understanding of the standards promulgated under paragraph (b).
(b) Develop, promulgate and revise as the Commissioner deems appropriate, standards in each of the several areas of insurance appropriate to be applied to policies sold in the State of Nevada. The standards must seek to ensure that policies are not unjust, unfair, inequitable, unfairly discriminatory, misleading, deceptive, obscure or encourage misrepresentation or misunderstanding of the contract.
(c) Develop criteria to determine the suitability of insurance contracts and the practices used in the sale of insurance.
2. This section does not prohibit an insurer from offering policies encompassing standards more favorable to the insured than those promulgated under this section.
(Added to NRS by 1971, 1564; A 1971, 1932; 2001, 2180)
1. Every insurer or organization for dental care which pays claims on the basis of fees for medical or dental care which are “usual and customary” shall submit to the Commissioner a complete description of the method it uses to determine those fees. Except as otherwise provided in NRS 239.0115, this information must be kept confidential by the Commissioner. The fees determined by the insurer or organization to be the usual and customary fees for that care are subject to the approval of the Commissioner as being the usual and customary fees in that locality. The provisions of this subsection apply to medical or dental care provided to a claimant under any contract of insurance.
2. Any contract for group, blanket or individual health insurance and any contract issued by a nonprofit hospital, medical or dental service corporation or organization for dental care, which provides a plan for dental care to its insureds or members which limits their choice of a dentist, under the plan to those in a preselected group, must offer its insureds or members the option of selecting a plan of benefits which does not restrict the choice of a dentist. The selection of that option does not entitle the insured or member to any increase in contributions by his or her employer or other organization toward the premium or cost of the optional plan over that contributed under the restricted plan.
1. Every insurer, agent, solicitor, broker, administrator or other person who has knowledge of a violation of any provision of this Code shall promptly report the facts and circumstances pertaining to the violation to the Commissioner.
2. Except as otherwise provided in NRS 239.0115, if a person who submits information pursuant to subsection 1 so requests, the Commissioner shall keep the person’s name and the information confidential.
(Added to NRS by 1985, 1063; A 2007, 2153)
1. The Commissioner may create advisory councils and committees to assist the Commissioner in dealing with regulatory problems. The Commissioner may appoint members and may provide by rule for the creation, governance, duties and termination of any council or committee the Commissioner establishes.
2. The Commissioner may create at least one advisory council to represent the consumer interest in insurance, to be made up of members with no substantial interest in any aspect of the insurance industry, except as insureds.
(Added to NRS by 1971, 1565)
NRS 679B.170 Private ombudsmen. The Commissioner may by rule or regulation require any or all insurers to designate a special complaint representative, who may be an officer, employee or agent, to investigate and report on complaints received from insureds or other persons. In order to achieve some degree of independence and authority in such representatives, the Commissioner may require that they report directly to the board of directors or other specified office, or that they have additional authority or status.
(Added to NRS by 1971, 1565; A 1971, 1933)
1. The Commissioner may invoke the aid of the courts through injunction or other proper process, mandatory or otherwise, to enjoin any existing or threatened violation of any provision of this Code, or to enforce any proper order made by or action taken by the Commissioner.
2. If the Commissioner has reason to believe that any person has violated any provision of this Code, or other law applicable to insurance operations, for which criminal prosecution in the opinion of the Commissioner would be in order, the Commissioner shall give the information relative thereto to the appropriate district attorney or to the Attorney General. The district attorney or Attorney General shall promptly institute such action or proceedings against such person as in the opinion of the district attorney or Attorney General the information may require or justify.
3. Except as otherwise provided in this Code, the Attorney General shall act as legal counsel to the Division and the Commissioner in all matters pertaining to the administration and enforcement of this Code.
1. If any person willfully engages in the unauthorized transaction of insurance, the Commissioner may impose an administrative fine of not more than $10,000 for each act or violation.
2. An administrative fine imposed pursuant to this section is in addition to any other administrative fine or penalty provided for in this title, except a fine or penalty imposed pursuant to NRS 686A.183, 686A.187, 696B.500 or 696B.520.
3. If the administrative fine is not paid when due, the fine must be recovered in a civil action brought by the Attorney General on behalf of the Commissioner.
4. Except as otherwise provided by specific statute, the Commissioner shall commence a proceeding to impose an administrative fine pursuant to subsection 1 not later than 5 years after the date on which the act or violation occurred.
1. An officer, director, employee or agent of a domestic or foreign insurer who has the duty or power of investing or handling the money or assets of the insurer located in this state is a fiduciary of that money or those assets. Such an officer, director, employee or agent shall not appropriate, divert or convert to his or her own use such money or assets.
2. A person who violates subsection 1 is guilty of embezzlement and, in addition to any other penalty provided by law, shall be punished in accordance with NRS 205.300.
(Added to NRS by 1997, 3016)
1. The Commissioner shall carefully preserve in the Division and in permanent form all papers and records relating to the business and transactions of the Division and shall hand them over to the successor in office of the Commissioner.
2. Except as otherwise provided in subsections 3 and 5 to 9, inclusive, other provisions of this Code and NRS 616B.015, the papers and records must be open to public inspection.
3. Except as otherwise provided in NRS 239.0115, any records or information in the possession of the Division related to an investigation conducted by the Commissioner is confidential unless:
(a) The Commissioner releases, in the manner that he or she deems appropriate, all or any part of the records or information for public inspection after determining that the release of the records or information:
(1) Will not harm the investigation or the person who is being investigated; or
(2) Serves the interests of a policyholder, the shareholders of the insurer or the public; or
(b) A court orders the release of the records or information after determining that the production of the records or information will not damage any investigation being conducted by the Commissioner.
4. The Commissioner may destroy unneeded or obsolete records and filings in the Division in accordance with provisions and procedures applicable in general to administrative agencies of this State.
5. The Commissioner may classify as confidential:
(a) Specified records and information obtained from a governmental agency; and
(b) Documents obtained or received from other sources upon the express condition that they remain confidential.
6. All information and documents in the possession of the Division or any of its employees which are related to cases or matters under investigation by the Commissioner or the staff of the Commissioner are confidential for the period of the investigation and may not be made public unless the Commissioner finds the existence of an imminent threat of harm to the safety or welfare of the policyholder, shareholders or the public and determines that the interests of the policyholder, shareholders or the public will be served by publication thereof, in which event the Commissioner may make a record public or publish all or any part of the record in any manner he or she deems appropriate.
7. The Commissioner may classify as confidential the records of a consumer or information relating to a consumer to protect the health, welfare or safety of the consumer.
8. In performing his or her duties, the Commissioner may:
(a) Share documents, materials or other information, including any documents, materials or information classified as confidential, with other state, federal and international regulatory or law enforcement agencies or with the National Association of Insurance Commissioners and its affiliates and subsidiaries if the recipient agrees to maintain the confidentiality and privileged status of the documents, materials or other information.
(b) May receive documents, materials or other information, including any documents, materials or information otherwise confidential and privileged, from other state, federal and international regulatory or law enforcement agencies or from the National Association of Insurance Commissioners and its affiliates and subsidiaries, and shall maintain as confidential or privileged any document, material or information received with notice or the understanding that it is confidential or privileged under the law of the jurisdiction from which it was received.
(c) Enter into agreements, consistent with this subsection, governing the sharing and use of information.
9. No waiver of confidentiality or privilege with respect to any document, material or information occurs as a result of disclosure to the Commissioner under this section or of sharing as authorized under this chapter.
1. All certificates issued by the Commissioner in accordance with the provisions of this Code and all copies of documents filed in his or her office in accordance with the provisions of this Code when certified by the Commissioner must be taken and received in all courts and public offices and by official bodies of this state as prima facie evidence of the facts therein stated.
2. A certificate by the Commissioner under the seal of the Division as to facts relating to insurers which would not appear from a certified copy of any of the documents or certificates specified in subsection 1 must be taken and received in all courts and public offices and by official bodies as prima facie evidence of the facts therein stated.
1. The Commissioner shall communicate on request of the regulatory officer for insurance in any state, province or country any information which it is the duty of the Commissioner by law to ascertain respecting authorized insurers.
2. The Commissioner may:
(a) Be a member of the National Association of Insurance Commissioners or any successor organization;
(b) Exchange with the association or any successor organization any information, not otherwise confidential, relating to applicants and licensees under this title;
(c) Communicate with the association or any successor organization concerning the business of insurance generally;
(d) Enter into compacts with the regulatory officers in other states to further the uniform treatment of insurers throughout the United States; and
(e) Participate in and support other cooperative activities of public officers having supervision of the business of insurance.
(Added to NRS by 1971, 1566; A 1987, 594; 2001, 2182)
NRS 679B.225 Inspection of insurance policies. The Commissioner, at any time, may inspect any insurance policy covering any risk in this state. Every policyholder, upon request, shall produce any insurance policy in his or her possession or under his or her control for inspection by the Commissioner.
(Added to NRS by 1977, 454)
NRS 679B.227 Statute of limitations for commencing proceedings to collect premium tax. The Commissioner has 7 years in which to begin proceedings to collect the premium tax and associated penalties and fines imposed pursuant to NRS 680B.027, 680B.039, 680B.040, 685A.180, 685A.190 and 685B.035, where the tax has been unreported or has been concealed by error or omission, and where the amount of the tax is known or through reasonable diligence should have been known.
(Added to NRS by 1995, 1611)
NRS 679B.228 Fee for returned check or other dishonored payment. The Division shall charge a person a fee in the amount established by the State Controller pursuant to NRS 353C.115 for each check or other method of payment that is returned to the Division or otherwise dishonored because the person had insufficient money or credit with the drawee or financial institution to pay the check or other method of payment or because the person stopped payment on the check or other method of payment.
1. For the purpose of determining its financial condition, fulfillment of its contractual obligations and compliance with law, the Commissioner shall, as often as he or she deems advisable, examine the affairs, transactions, accounts, records and assets of each authorized insurer, and of any person as to any matter relevant to the financial affairs of the insurer or to the examination. Except as otherwise expressly provided in this title, the Commissioner shall so examine each authorized insurer not less frequently than every 5 years. Examination of an alien insurer must be limited to its insurance transactions, assets, trust deposits and affairs in the United States, except as otherwise required by the Commissioner.
2. The Commissioner shall in like manner examine each insurer applying for an initial certificate of authority to transact insurance in this state.
3. In lieu of an examination under this chapter, the Commissioner may accept a report of the examination of a foreign or alien insurer prepared by the Division for a foreign insurer’s state of domicile or an alien insurer’s state of entry into the United States.
4. As far as practical the examination of a foreign or alien insurer must be made in cooperation with the insurance supervisory officers of other states in which the insurer transacts business.
(Added to NRS by 1971, 1567; A 1995, 1750)
NRS 679B.240 Examination of holding companies, subsidiaries, agents, promoters, independent review organizations and others. To ascertain compliance with law, or relationships and transactions between any person and any insurer or proposed insurer, the Commissioner may, as often as he or she deems advisable, examine the accounts, records, documents and transactions relating to such compliance or relationships of:
1. Any insurance agent, solicitor, broker, surplus lines broker, general agent, adjuster, insurer representative, bail agent, motor club agent or any other licensee or any other person the Commissioner has reason to believe may be acting as or holding himself or herself out as any of the foregoing.
2. Any person having a contract under which the person enjoys in fact the exclusive or dominant right to manage or control an insurer.
3. Any insurance holding company or other person holding the shares of voting stock or the proxies of policyholders of a domestic insurer, to control the management thereof, as voting trustee or otherwise.
4. Any subsidiary of the insurer.
5. Any person engaged in this state in, or proposing to be engaged in this state in, or holding himself or herself out in this state as so engaging or proposing, or in this state assisting in, the promotion, formation or financing of an insurer or insurance holding corporation, or corporation or other group to finance an insurer or the production of its business.
6. Any independent review organization, as defined in NRS 695G.026.
1. When the Commissioner determines to examine the affairs of any person, the Commissioner shall designate one or more examiners and instruct them as to the scope of the examination. The examiner shall, upon demand, exhibit the official credentials of the examiner to the person under examination.
2. The Commissioner shall conduct each examination in an expeditious, fair and impartial manner.
3. Upon any such examination the Commissioner, or the examiner if specifically so authorized in writing by the Commissioner, may administer oaths, and examine under oath any person as to any matter relevant to the affairs under examination or relevant to the examination.
4. Every person being examined, its officers, attorneys, employees, agents and representatives shall make freely available to the Commissioner or the examiners of the Commissioner the accounts, records, documents, files, information, assets and matters of the person examined in his or her possession or control relating to the subject of the examination and shall facilitate the examination.
5. If the Commissioner or examiner finds any accounts or records to be inadequate, or inadequately kept or posted, the Commissioner may employ experts to reconstruct, rewrite, post or balance them at the expense of the person being examined if that person has failed to maintain, complete or correct the records or accounting after the Commissioner or examiner has given the person written notice and a reasonable opportunity to do so.
6. Neither the Commissioner nor any examiner may remove any record, account, document, file or other property of the person being examined from the offices or place of the person examined except with the written consent of the person before removal or pursuant to an order of court duly obtained. This provision does not affect the making and removal of copies or abstracts of any such record, account, document or file.
7. Any person who refuses without just cause to be examined under oath or who willfully obstructs or interferes with the examiners in the exercise of their authority pursuant to this section is guilty of a misdemeanor.
8. This chapter does not limit the Commissioner’s authority:
(a) To terminate or suspend an examination in order to pursue other legal or regulatory action.
(b) During any hearing or any legal action, to use and, if so ordered by a court, to make public a final or preliminary report of an examination, working papers or other documents of an examiner or insurer, or any other information discovered or developed during the course of an examination. Such documents must be given their appropriate evidentiary weight and must not be accepted as prima facie evidence of the facts contained therein.
(Added to NRS by 1971, 1567; A 1995, 1750)
1. If the Commissioner deems it necessary to value any asset involved in such an examination, the Commissioner may make written request of the person being examined to appoint one or more appraisers who by reason of education, experience or special training, and disinterest, are competent to appraise the asset. Selection of any such appraiser shall be subject to the written approval of the Commissioner. If no such appointment is made within 10 days after the request therefor was delivered to such person, the Commissioner may appoint the appraiser or appraisers.
2. Any such appraisal shall be expeditiously made, and a copy thereof furnished to the Commissioner and to the person being examined.
3. The reasonable expense of the appraisal shall be borne by the person being examined.
(Added to NRS by 1971, 1568)
1. No later than 60 days after the completion of an examination, the examiner designated by the Commissioner shall make a true report thereof which must comprise only facts appearing upon the books, records or other documents of the person examined, or as ascertained from the sworn testimony of the officers or agents or other persons examined concerning its affairs, and such conclusions and recommendations as may reasonably be warranted from the facts. The report of examination must be verified by the oath of the examiner making the report.
2. Such a report of examination of an insurer so verified is prima facie evidence in any action or proceeding for the receivership, conservation or liquidation of the insurer brought in the name of the state against the insurer, its officers or agents upon the facts stated therein.
(Added to NRS by 1971, 1569; A 1977, 693; 1995, 1751)
1. Upon receipt of the verified report of the examination, the Commissioner shall deliver a copy of the report to the person examined, together with a notice affording the person 10 days or such additional reasonable period as the Commissioner for good cause may allow within which to review the report and make a written submission or rebuttal with respect to recommended changes or any matters contained in the report.
2. Within 30 days after the end of the period allowed for the receipt of written submissions or rebuttals, the Commissioner shall fully consider and review the report, together with any written submissions or rebuttals and any relevant portions of the examiner’s working papers and enter an order:
(a) Adopting the report as filed or with modification or corrections;
(b) Rejecting the report with directions to the examiner to reopen the examination for purposes of obtaining additional data, documentation or information, and requiring the refiling of the report pursuant to subsection 1 of NRS 679B.270; or
(c) For an investigatory hearing for purposes of obtaining additional documentation, data, information and testimony.
3. If the report reveals that the insurer is operating in violation of any law, regulation or previous order of the Commissioner, the Commissioner may order the insurer to take any action the Commissioner considers necessary or appropriate to cure the violation.
1. If requested by the person examined, within the period allowed under subsection 1 of NRS 679B.280, or if ordered pursuant to subsection 2 of that section, the Commissioner shall hold a hearing relative to the report and shall not file the report in the Division for public inspection until after the hearing and the order of the Commissioner thereon.
2. If no hearing has been requested or ordered, the examination report, with such modifications, if any, thereof as the Commissioner deems proper, must be filed in the Division for public inspection within 30 days after the expiration of the period allowed for review by the person examined. Otherwise the report must be so filed within 30 days after final hearing thereon, except that the Commissioner may withhold from public inspection any report for so long as the Commissioner deems such withholding to be necessary for the protection of the person examined against unwarranted injury or to be in the public interest.
3. The Commissioner shall forward to the person examined a copy of the examination report as filed, together with any recommendations or statements relating thereto which the Commissioner deems proper.
4. If the report concerns the examination of a domestic insurer, a copy of the report, or a summary thereof approved by the Commissioner must be presented by the insurer’s chief executive officer to the insurer’s board of directors or similar governing body at its next regular board meeting. A copy of the report must also be furnished by the secretary of the insurer, if incorporated, or by the attorney-in-fact if a reciprocal insurer, within 30 days after receipt of the report in final form by the insurer, to each member of the insurer’s board of directors or board of governors, if a reciprocal insurer, and the certificate of the secretary or attorney-in-fact that a copy of the examination report has been so furnished shall be deemed to constitute knowledge of the contents of the report by each such member.
(Added to NRS by 1995, 1749)
1. The Commissioner may disclose the content of a report, preliminary report, or the results of an examination, or any matter relating thereto, to the Division or any agency of any other state or country that regulates insurance, or to law enforcement officers of this or any other state, or to an agency of the Federal Government at any time, if the agency or office receiving the report or matter relating thereto agrees in writing to hold it confidential in a manner consistent with this chapter. Access may also be granted to the National Association of Insurance Commissioners.
2. All working papers, recorded information, documents and copies thereof produced by, obtained by or disclosed to the Commissioner or any other person in the course of an examination made under this chapter are confidential, are not subject to subpoena, and may not be made public by the Commissioner or any other person, except as necessary for a hearing or as provided in this section, subsection 4 of NRS 679B.282 and NRS 239.0115. A person to whom information is given must agree in writing before receiving the information to provide to it the same confidential treatment as required by this section, unless the prior written consent of the insurer to which it pertains has been obtained.
NRS 679B.287 Limitations on actions and liability for communicating or delivering information or data pursuant to examination; Commissioner, representatives and examiners entitled to attorney’s fees and costs in certain tort actions.
1. No cause of action arises, nor may any liability be imposed against any person for the act of communicating or delivering information or data to the Commissioner or any authorized representative or examiner of the Commissioner pursuant to an examination made under this chapter, if the act of communication or delivery was performed in good faith and without fraudulent intent, the intent to deceive or gross negligence.
2. The Commissioner, his or her authorized representative or any examiner appointed by the Commissioner is entitled to an award of attorney’s fees and costs if he or she is the prevailing party in a civil cause of action for libel, slander or any other relevant tort arising out of activities in carrying out the provisions of NRS 679B.230 to 679B.300, inclusive, and the party bringing the action was not substantially justified in doing so. For the purposes of this subsection, an action is “substantially justified” if it had a reasonable basis in law or fact at the time that it was brought.
(Added to NRS by 1995, 1748)
1. Except as otherwise provided in subsection 2:
(a) The expense of examination of an insurer, or of any person referred to in subsection 1, 2, 5 or 6 of NRS 679B.240, must be borne by the person examined. Such expense includes only the reasonable and proper hotel and travel expenses of the Commissioner and the examiners and assistants of the Commissioner, including expert assistance, reasonable compensation as to such examiners and assistants and incidental expenses as necessarily incurred in the examination. As to expense and compensation involved in any such examination, the Commissioner shall give due consideration to scales and limitations recommended by the National Association of Insurance Commissioners and outlined in the examination manual sponsored by that association.
(b) The person examined shall promptly pay to the Commissioner the expenses of the examination upon presentation by the Commissioner of a reasonably detailed written statement thereof.
2. The Commissioner may bill an insurer for the examination of any person referred to in subsection 1 of NRS 679B.240 and shall adopt regulations governing such billings.
1. The Insurance Examination Account is hereby created as an account in the Fund for Insurance Administration and Enforcement created by NRS 680C.100. All money received by the Commissioner pursuant to NRS 679B.290 must be deposited in the State Treasury for credit to the Account.
2. Money for travel, per diem, compensation and other necessary and authorized expenses incurred by an examiner or other representative of the Division in the examination of any person required to pay, and making payment of, the expense of examination pursuant to NRS 679B.290 must be paid out of the Insurance Examination Account as other claims against the State are paid.
3. Money in the Insurance Examination Account may be expended for any other purpose authorized by the Legislature.
INSURANCE RECOVERY ACCOUNT
1. There is hereby created the Insurance Recovery Account in the Fund for Insurance Administration and Enforcement created by NRS 680C.100. The Commissioner shall promptly deposit with the State Treasurer for credit to the Account all recovery fees received from licensees pursuant to the provisions of this title.
2. A balance of not more than $40,000 must be maintained in the Account to be used for satisfying claims against persons licensed pursuant to chapters 683A, 684A, 685A and 692A of NRS. Any balance over $40,000 in the Account at the end of any fiscal year must be set aside and used by the Commissioner for insurance education and research or for any other purpose authorized by the Legislature.
3. The Commissioner shall adopt reasonable regulations for the administration of the Account, including the manner, time, procedure and grounds for recovery against the Account.
4. The limit of liability of the insurance recovery account is $5,000 per fiscal year for any one licensee.
1. The Commissioner may hold a hearing, without request by others, to determine whether an insurer or an employee of an insurer has engaged in unsuitable conduct and for any other purpose within the scope of this Code.
2. The Commissioner shall hold a hearing:
(a) If required by any other provision of this Code; or
(b) Upon written application for a hearing by a person aggrieved by any act, threatened act, or failure of the Commissioner to act, or by any report, rule, regulation or order of the Commissioner, other than an order for the holding of a hearing, or an order issued on a hearing of which the person had notice. The application must be filed in the Division within 60 days after the person knew or reasonably should have known of the act, threatened act, failure, report, rule, regulation or order, unless a different period is provided for by any other law applicable to the particular matter, in which case the other law governs.
3. Any such application for a hearing must briefly state the respects in which the applicant is so aggrieved, together with the grounds to be relied upon as a basis for the relief to be sought at the hearing.
4. If the Commissioner finds that the application is made in good faith, that the applicant would be so aggrieved if his or her grounds are established and that the grounds otherwise justify the hearing, the Commissioner shall hold the hearing within 30 days after the filing of the application, unless postponed by mutual consent. Failure to hold the hearing upon application therefor of a person entitled thereto as provided in this section constitutes a denial of the relief sought, and is the equivalent of a final order of the Commissioner on hearing for the purpose of an appeal pursuant to NRS 679B.370.
5. Pending the hearing and decision thereon, the Commissioner may suspend or postpone the effective date of the previous action of the Commissioner.
1. Except where a different period is expressly provided, the Commissioner shall give written notice of the hearing not less than 20 days in advance. The notice shall state the date, time and place of the hearing and specify the matters to be considered thereat. If the persons to be given notice are not specified in the provision pursuant to which the hearing is held, the Commissioner shall give such notice to all persons whose pecuniary interest, to the Commissioner’s knowledge or belief, are to be directly and immediately affected by the hearing.
2. If any person is entitled to a hearing by any provision of this Code before any proposed action is taken, the notice of the hearing may be in the form of a notice to show cause, stating that the proposed action may be taken unless such person shows cause at a hearing to be held as specified in the notice why the proposed action should not be taken, and stating the basis of the proposed action.
3. If any such hearing is to be held for consideration of rules and regulations of the Commissioner, or of other matters which, under subsection 1, would otherwise require separate notices to more than 30 persons, in lieu of other notice the Commissioner may give notice of the hearing by publication thereof in a newspaper of general circulation in this state, at least once each week during the fourth and second weeks next preceding the week in which the hearing is to be held; but the Commissioner shall mail such notice to all persons who had requested the same in writing in advance and had paid to the Commissioner the reasonable amount fixed by the Commissioner to cover the cost thereof.
4. All such notices, other than published notices, shall be given as provided in NRS 679B.140.
(Added to NRS by 1971, 1571)
1. The Commissioner may hold a hearing in Carson City, Nevada, or any other place of convenience to parties and witnesses, as the Commissioner determines. The Commissioner, a deputy or assistant of the Commissioner, or a person appointed by the Commissioner, shall preside at the hearing, and shall expedite the hearing and all procedures involved therein.
2. The Commissioner may appoint a person who is not associated with the Division to conduct a hearing if the hearing requires a disinterested or impartial hearing officer. A person so appointed shall comply with the provisions which govern hearings conducted by the Commissioner. An order issued by such a person has the same effect as an order issued by the Commissioner.
3. Testimony may be taken orally or by deposition, and any party has the same right to introduce evidence by interrogatories or deposition as the party would have in a district court.
4. Upon good cause shown the Commissioner shall permit to become a party to the hearing by intervention, if timely, only such persons, not original parties thereto, whose pecuniary interests are to be directly and immediately affected by the Commissioner’s order made upon the hearing.
5. The Commissioner shall cause a record of the proceedings to be made. If transcribed, a copy of the record must be part of the Commissioner’s record of the hearing and a copy must be furnished to any other party to the hearing, at the request and expense of the other party. If no such record is transcribed, the Commissioner shall prepare a summary record of the proceedings and evidence.
1. The Commissioner or any individual conducting a hearing, examination or investigation by the authority of the Commissioner shall have power to subpoena witnesses, compel their attendance, administer oaths, examine any person under oath relative to the subject of the hearing, examination or investigation, and to compel any person to subscribe to his or her testimony after it has been correctly reduced to writing, and, in connection therewith, to require the production of any books, papers, records, correspondence or other documents which the Commissioner or the individual conducting the hearing, examination or investigation deems relevant to the inquiry. Any delegation by the Commissioner of the power to administer oaths or of subpoena shall be in writing.
2. A subpoena issued pursuant to this section shall have the same force and effect and shall be served in the same manner as if issued from a court of record.
3. If any individual fails to obey a subpoena, or refuses to testify as to any matter concerning which he or she may lawfully be interrogated, the Commissioner may file a written report thereof and proof of service of the subpoena in any court of competent jurisdiction in the county where the examination or hearing is being conducted, for such action as the court may determine.
4. Witness fees and mileage, if claimed, shall be allowed the same as for testimony in a court of record, but no officer, director, agent or employee of an insurer or person being examined or investigated shall be entitled to witness or mileage fees.
5. Every person subpoenaed under this section who willfully fails to appear at the time and place named in the subpoena or to produce documents required by the subpoena, or who refuses to be sworn or answer as a witness, is guilty of a misdemeanor.
(Added to NRS by 1971, 1572)
1. If any individual asks to be excused from attending or testifying or from producing any books, papers, records, contracts, correspondence or other documents in connection with any examination, hearing or investigation being conducted by the Commissioner or an examiner of the Commissioner, on the ground that the testimony or evidence required of the individual may tend to incriminate the individual or subject him or her to a penalty or forfeiture, and nonetheless is directed by the Attorney General to give such testimony or produce such evidence, the individual must comply with such direction; but the individual shall not thereafter be prosecuted or subjected to any penalty or forfeiture for or on account of any transaction, matter or thing concerning which he or she may have so testified or produced evidence, and no testimony so given or evidence produced shall be received against him or her upon any criminal action, investigation or proceeding. No such individual so testifying shall be exempt from:
(a) Prosecution or punishment for any perjury committed by the individual in such testimony, and the testimony or evidence so given or produced shall be admissible against the individual upon any criminal action, investigation or proceeding concerning such perjury.
(b) The refusal, suspension or revocation of any license, permission or authority conferred, pursuant to this Code.
2. Any such individual may execute, acknowledge and file in the office of the Commissioner and of the Attorney General a statement expressly waiving such immunity or privilege in respect to any transaction, matter or thing specified in such statement, and thereupon the testimony of such individual or such evidence in relation to such transaction, matter or thing may be received or produced before any judge or justice, court, tribunal, grand jury or otherwise, and if such testimony or evidence is so received or produced such individual shall not be entitled to any immunity or privileges on account of any testimony or evidence the individual may so give or produce.
(Added to NRS by 1971, 1573)
1. In the conduct of hearings under this Code and making an order thereon, the Commissioner shall act in a quasi-judicial capacity.
2. Except as otherwise provided in this subsection, within 30 days after termination of a hearing, or of any rehearing thereof or reargument thereon, or within such other period as may be specified in this Code as to particular proceedings, the Commissioner shall make an order on hearing covering matters involved in such hearing, and give a copy of the order to each party to the hearing in the same manner as notice of the hearing was given to such party. With respect to hearings held concerning merger, consolidation, bulk reinsurance, conversion, affiliation or change of control of a domestic insurer as provided in chapter 693A of NRS (corporate powers, procedures of domestic stock and mutual insurers), where notice of the hearing was given to all stockholders and policyholders or to all stockholders or policyholders of an insurer involved, the Commissioner is required to give a copy of the order on hearing to the corporation and insurer parties, to intervening parties, to a reasonable number of such stockholders or policyholders as representative of the class, and to other parties only upon written request of such parties.
3. The order shall contain:
(a) A concise statement of facts found by the Commissioner upon evidence adduced at the hearing;
(b) A concise statement of the Commissioner’s conclusions from the facts so found;
(c) The order, and the effective date thereof; and
(d) Citation of the provisions of this Code upon which the order is based; but failure so to designate a particular provision shall not deprive the Commissioner of the right thereafter to rely thereon.
4. The order may affirm, modify or rescind action theretofore taken or may constitute taking of new action within the scope of the notice of the hearing.
(Added to NRS by 1971, 1573)
1. Except as to matters arising under chapter 686B of NRS other than those grievances of employers that must be appealed to the appeals panel for industrial insurance, an appeal from the Commissioner must be taken only from an order on hearing, or as to a matter on which the Commissioner has refused or failed to hold a hearing after application therefor under NRS 679B.310, or as to a matter concerning which the Commissioner has refused or failed to make an order on hearing as required by NRS 679B.360.
2. Any person who was a party to a hearing or whose pecuniary interests are directly and immediately affected by any such refusal or failure, and who is aggrieved by the order, refusal or failure, may petition for judicial review in the manner provided by chapter 233B of NRS.
1. Except as otherwise expressly provided in this Code, funds with which to carry out the administration and enforcement by the Commissioner of this Code shall be provided by the Fund for Insurance Administration and Enforcement created by NRS 680C.100 and shall be paid out on claims as other claims against the State are paid.
2. No such claim shall be paid unless approved by the Commissioner.
(Added to NRS by 1971, 1575; A 2009, 1764)
STABILIZATION OF INSURANCE COSTS
1. The Legislature finds and declares that:
(a) Stabilizing the cost of insurance is of vital concern to the residents of this state; and
(b) It is necessary to establish a comprehensive system to collect, analyze and distribute information concerning the cost of insurance in order to stabilize that cost effectively.
(a) Promote the public welfare by studying the relationship of premiums and related income of insurers to costs and expenses of insurers;
(b) Develop measures to stabilize prices for insurance while continuing to provide insurance of high quality to the residents of this state;
(c) Permit and encourage competition between insurers on a sound financial basis to the fullest extent possible;
(d) Establish a mechanism to ensure the provision of adequate insurance at reasonable rates to the residents of this state; and
(e) Protect the rights of customers of insurance in this state.
1. Determine the relationship of premiums and related income of insurers to costs and expenses of insurers, provide this information to the Legislature and make this information available to the general public.
3. Report to each regular session of the Legislature concerning his or her duties and findings pursuant to this section no later than February 1.
NRS 679B.420 Employment of technical and professional consultants. The Commissioner may employ and fix the compensation of, and enter into agreements with, such technical and professional consultants as the Commissioner deems necessary to accomplish the purposes of NRS 679B.400 to 679B.460, inclusive.
(Added to NRS by 1989, 1227)
2. The Commissioner shall adopt regulations requiring each insurer authorized to transact casualty or property insurance in this state to record and report its losses, expenses and other information necessary to assess the relationship of premiums and related income to costs and expenses of insurers. The Commissioner may designate one or more rate service organizations or other advisory organizations to gather and compile this information. The Commissioner shall require each insurer authorized to transact casualty or property insurance in this state to submit reports, on forms furnished by the Commissioner, of its transactions in insurance in this state and elsewhere.
3. If a rate service organization or other advisory organization designated pursuant to subsection 2 imposes a fee for the filing, processing or review of information required to be filed by this section, the insurer shall pay that fee and file the information.
(Added to NRS by 1989, 1227)
1. The Commissioner may require that reports submitted pursuant to NRS 679B.430 include, without limitation, information regarding:
(a) Liability insurance provided to:
(1) Governmental agencies and political subdivisions of this State, reported separately for:
(I) Cities and towns;
(II) School districts; and
(III) Other political subdivisions;
(2) Public officers;
(3) Establishments where alcoholic beverages are sold;
(4) Facilities for the care of children;
(5) Labor, fraternal or religious organizations; and
(6) Officers or directors of organizations formed pursuant to title 7 of NRS, reported separately for nonprofit entities and entities organized for profit;
(b) Liability insurance for:
(1) Defective products;
(2) Medical or dental malpractice of:
(II) A hospital or other health care facility; or
(III) Any related corporate entity.
(3) Malpractice of attorneys;
(4) Malpractice of architects and engineers; and
(5) Errors and omissions by other professionally qualified persons;
(c) Vehicle insurance, reported separately for:
(1) Private vehicles;
(2) Commercial vehicles;
(3) Liability insurance; and
(4) Insurance for property damage;
(d) Workers’ compensation insurance; and
(e) In addition to any information provided pursuant to subparagraph (2) of paragraph (b) or NRS 690B.260, a policy of insurance for medical malpractice. As used in this paragraph, “policy of insurance for medical malpractice” has the meaning ascribed to it in NRS 679B.144.
2. The Commissioner may require that the report include, without limitation, information specifically pertaining to this State or to an insurer in its entirety, in the aggregate or by type of insurance, and for a previous or current year, regarding:
(a) Premiums directly written;
(b) Premiums directly earned;
(c) Number of policies issued;
(d) Net investment income, using appropriate estimates when necessary;
(e) Losses paid;
(f) Losses incurred;
(g) Loss reserves, including:
(1) Losses unpaid on reported claims; and
(2) Losses unpaid on incurred but not reported claims;
(h) Number of claims, including:
(1) Claims paid; and
(2) Claims that have arisen but are unpaid;
(i) Expenses for adjustment of losses, including allocated and unallocated losses;
(j) Net underwriting gain or loss;
(k) Net operation gain or loss, including net investment income; and
(l) Any other information requested by the Commissioner.
3. The Commissioner may also obtain, based upon an insurer in its entirety, information regarding:
(a) Recoverable federal income tax;
(b) Net unrealized capital gain or loss; and
(c) All other expenses not included in subsection 2.
1. Insurers required to file reports pursuant to NRS 679B.430 shall pay to the Division a reasonable fee established by the Commissioner of not more than $500 to cover the costs to the Division of the administration and enforcement of NRS 679B.400 to 679B.460, inclusive, including any expenses incident or associated with the requirements of those sections.
2. The cost of furnishing a report, unless furnished to a Legislator, must be paid by the party requesting the report.
3. The Commissioner may establish a schedule of fees for the purposes of this section.
4. The Stabilization of Insurance Costs Account is hereby created as an account in the Fund for Insurance Administration and Enforcement created by NRS 680C.100. All money received by the Commissioner pursuant to this section must be deposited in the State Treasury for credit to the Account and used to pay the costs of administration and enforcement of NRS 679B.400 to 679B.460, inclusive.
1. An insurer who willfully or repeatedly violates or fails to comply with a provision of NRS 679B.400 to 679B.450, inclusive, or 690B.260 or a regulation adopted pursuant to NRS 679B.430 is subject, after notice and a hearing held pursuant to NRS 679B.310 to 679B.370, inclusive, to payment of an administrative fine of not more than $1,000 for each day of the violation or failure to comply, up to a maximum fine of $50,000.
2. An insurer who fails or refuses to comply with an order issued by the Commissioner pursuant to NRS 679B.430 is subject, after notice and a hearing held pursuant to NRS 679B.310 to 679B.370, inclusive, to suspension or revocation of the insurer’s certificate of authority to transact insurance in this state.
3. The imposition of an administrative fine pursuant to this section must not be considered by the Commissioner in any other administrative proceeding unless the fine has been paid or a court order for payment of the fine has become final.
(Added to NRS by 1989, 1229; A 2003, 3279)
PROTECTIONS FOR CONSUMERS OF HEALTH CARE
NRS 679B.510 Definitions. As used in NRS 679B.510 to 679B.560, inclusive, unless the context otherwise requires, the words and terms defined in NRS 679B.520, 679B.530 and 679B.540 have the meanings ascribed to them in those sections.
NRS 679B.520 “Health care plan” defined. “Health care plan” means a policy, contract, certificate or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.
(Added to NRS by 1971, 1731)
(Added to NRS by 1997, 1731)
NRS 679B.540 “Insurer” defined. “Insurer” means any insurer or organization authorized pursuant to this title to conduct business in this state that provides or arranges for the provision of health care services, including, without limitation, an insurer that issues a policy of health insurance, an insurer that issues a policy of group health insurance, a carrier serving small employers, a fraternal benefit society, a hospital or medical service corporation, a health maintenance organization, a plan for dental care and a prepaid limited health service organization.
(Added to NRS by 1997, 1731)
1. Establish a toll-free telephone service for receiving inquiries and complaints from consumers of health care in this State concerning health care plans;
2. Provide answers to inquiries of consumers of health care concerning health care plans, or refer the consumers to the appropriate agency, department or other entity that is responsible for addressing the specific type of inquiry;
3. Refer consumers of health care to the appropriate agency, department or other entity that is responsible for addressing the specific type of complaint of the consumer;
4. Provide counseling and assistance to consumers of health care concerning health care plans;
5. Educate consumers of health care concerning health care plans in this State; and
6. Take such actions as are necessary to ensure public awareness of the existence and purpose of the services provided by the Division pursuant to this section.
(Added to NRS by 1997, 1731)
1. The telephone number of the toll-free telephone service which is established pursuant to NRS 679B.550; and
2. The name of the Division and its hours of operation, including, but not limited to, the hours of operation of the toll-free telephone service.
(Added to NRS by 1997, 1732)
NRS 679B.600 Definitions. As used in NRS 679B.600 to 679B.700, inclusive, unless the context otherwise requires, the words and terms defined in NRS 679B.610 and 679B.620 have the meanings ascribed to them in those sections.
(Added to NRS by 2001, 1093)
NRS 679B.610 “Fraud Control Unit” defined. “Fraud Control Unit” means the Fraud Control Unit for Insurance established by the Attorney General pursuant to NRS 228.412.
(Added to NRS by 2001, 1093)
NRS 679B.620 “Insurance fraud” defined. “Insurance fraud” has the meaning ascribed to it in NRS 686A.2815.
(Added to NRS by 2001, 1093)
2. Defrauds or is an attempt to defraud an insurer.
NRS 679B.640 Commissioner required to investigate fraudulent claims for benefits. The Commissioner, through his or her investigators, shall investigate fraudulent claims for benefits under an insurance policy.
(Added to NRS by 1983, 1385; A 1993, 2541)
NRS 679B.650 Investigative authority of Commissioner. To investigate violations of the provisions of this title, or to assist the Attorney General or other local, state or federal investigative and law enforcement agencies in investigating an act of insurance fraud, the Commissioner may:
2. Conduct investigations into such activities occurring outside this state, if necessary. To conduct these investigations, the Commissioner or the investigators of the Commissioner may:
(a) Travel outside this state;
(b) Cooperate with appropriate agencies or persons outside this state; or
(c) Designate those agencies to conduct investigations for the Commissioner.
3. Assist officials of investigative or law enforcement agencies of any other state or the Federal Government who are investigating fraudulent claims and who request assistance from the Commissioner.
1. Every person in charge of an investigative or law enforcement agency within this state shall:
(a) Cooperate with the Commissioner and the investigators of the Commissioner, and the Attorney General and the members of the Fraud Control Unit; and
(b) Upon request, furnish the Commissioner or Attorney General, as appropriate, with any information necessary for the investigation of insurance fraud.
2. The Commissioner and the Attorney General shall:
(a) Assist any official of an investigative or a law enforcement agency of this state, any other state or the Federal Government who requests assistance in investigating any act of insurance fraud; and
(b) Furnish to those officials any information, not otherwise confidential, concerning his or her investigation or his or her report on insurance fraud.
(Added to NRS by 1983, 1385; A 2001, 1094)
NRS 679B.670 Liability for disclosure of information on fraudulent claim or suspicious fire. Any person, governmental entity, insurer, employee or representative of an insurer, official of an investigative or law enforcement agency, employee of the Division, the Commissioner, the Attorney General or a member of the Fraud Control Unit is not subject to a criminal penalty or subject to civil liability for libel, slander or any similar cause of action in tort if he or she, without malice, discloses information on a fraudulent claim or suspicious fire.
NRS 679B.680 Effect of certain powers and duties of Attorney General and Fraud Control Unit on jurisdiction of Commissioner. Nothing in NRS 228.412 limits or diminishes the exclusive jurisdiction of the Commissioner otherwise granted by statute to investigate or take administrative or civil action:
1. For any violation of this title by any person or entity who is or has been licensed by the Commissioner pursuant to this title;
2. Against any person or entity who is or has been engaged in the business of insurance without a license as required by this title, including, without limitation, the unauthorized transaction of insurance in violation of chapter 685B of NRS; or
3. Against any person or entity as the Commissioner deems appropriate.
(Added to NRS by 2001, 1093)
1. Except as otherwise provided in NRS 239.0115, all records and other information related to an investigation conducted by the Attorney General and the Fraud Control Unit for the prosecution of insurance fraud are confidential unless:
(a) The Attorney General releases, in such manner as he or she deems appropriate, all or any part of the records or information for public inspection after determining that the release of the records or information:
(1) Will not harm the investigation or the person who is being investigated; or
(2) Serves the interests of a policyholder, the shareholders of the insurer or the public; or
(b) A court orders the release of the records or information after determining that the production of the records or information will not damage any investigation being conducted by the Fraud Control Unit.
2. The Attorney General may classify as confidential specific records and other information if the records or other information was obtained from a governmental agency or other source upon the express condition that the contents would remain confidential.
3. All information and documents in the possession of the Attorney General and the Fraud Control Unit that are related to cases or matters under investigation are confidential for the duration of the investigation and may not be made public unless the Attorney General finds the existence of an imminent threat of harm to the safety or welfare of the policyholder, shareholders or the public and determines that the interests of the policyholder, shareholders or the public will be served by publication thereof, in which event the Attorney General may make a record public or publish all or any part of the record in any manner the Attorney General deems appropriate.
1. The Special Investigative Account is hereby established in the Fund for Insurance Administration and Enforcement created by NRS 680C.100 for use by the Commissioner. The Commissioner shall deposit all money received pursuant to this section with the State Treasurer for credit to the Account. Money remaining in the Account at the end of a fiscal year does not lapse to the State General Fund and may be used by the Commissioner in any subsequent fiscal year for the purposes of this section.
2. The Commissioner shall:
(a) In cooperation with the Attorney General, biennially prepare and submit to the Governor, for inclusion in the executive budget, a proposed budget for the program established pursuant to NRS 679B.630; and
(b) Authorize expenditures from the Special Investigative Account to pay the expenses of the program established pursuant to NRS 679B.630 and of any unit established in the Office of the Attorney General that investigates and prosecutes insurance fraud.
3. The money authorized for expenditure pursuant to paragraph (b) of subsection 2 must be distributed in the following manner:
(a) Fifteen percent of the money authorized for expenditure must be paid to the Commissioner to oversee and enforce the program established pursuant to NRS 679B.630; and
(b) Eighty-five percent of the money authorized for expenditure must be paid to the Attorney General to pay the expenses of the unit established in the Office of the Attorney General that investigates and prosecutes insurance fraud.
4. Except as otherwise provided in subsections 5 and 6, costs of the program established pursuant to NRS 679B.630 must be paid by the insurers authorized to transact insurance in this State. The Commissioner shall annually determine the total cost of the program and divide that amount among the insurers pro rata based upon the total amount of premiums charged to the insureds in this State by the insurer.
5. The annual amount so assessed on each reinsurer that has the authority to assume only reinsurance must not exceed $500. For all other insurers subject to the annual assessment, the annual amount so assessed to each insurer:
(a) Must not exceed $500, if the total amount of the premiums charged to insureds in this State by the insurer is less than $100,000;
(b) Must not exceed $750, if the total amount of the premiums charged to insureds in this State by the insurer is $100,000 or more, but less than $1,000,000;
(c) Must not exceed $1,000, if the total amount of the premiums charged to insureds in this State by the insurer is $1,000,000 or more, but less than $10,000,000;
(d) Must not exceed $1,500, if the total amount of the premiums charged to insureds in this State by the insurer is $10,000,000 or more, but less than $50,000,000; and
(e) Must not exceed $2,000, if the total amount of the premiums charged to insureds in this State by the insurer is $50,000,000 or more.
6. The provisions of this section do not apply to an insurer who provides only workers’ compensation insurance and pays the assessment provided in NRS 232.680.
7. The Commissioner shall adopt regulations to carry out the provisions of this section, including, without limitation, the calculation and collection of the assessment.
8. As used in this section, “reinsurer” has the meaning ascribed to it in NRS 681A.370.