[Rev. 1/25/2023 4:12:06 PM--2022R1]
NRS 686A.010 Purpose.
NRS 686A.015 Jurisdiction of Commissioner; Commissioner required to establish program to investigate unfair and deceptive trade practices.
NRS 686A.020 Unfair methods of competition and unfair or deceptive acts or practices prohibited.
NRS 686A.025 Unfair acts and practices: Disclosure of nonpublic personal information in manner contrary to federal law; regulations.
NRS 686A.027 Unfair or deceptive methods, acts or practices: Knowing access or use of contractual discount of provider of health care pursuant to provider network contract without applicable contractual relationship.
NRS 686A.030 Misrepresentation and false or misleading advertising of policies prohibited.
NRS 686A.040 False, deceptive or misleading information and advertising prohibited.
NRS 686A.050 “Twisting” prohibited.
NRS 686A.055 Use of existence of Nevada Insurance Guaranty Association or Nevada Life and Health Insurance Guaranty Association to induce purchase of or discourage termination of insurance covered by Association prohibited; exception.
NRS 686A.060 Replacement of life insurance: Statements required to be given to policyholder.
NRS 686A.070 Falsification of or knowing omissions in records or falsification of financial statements prohibited; penalty.
NRS 686A.080 Defamatory statement concerning person engaged or proposing to engage in business of insurance prohibited.
NRS 686A.085 Bank prohibited from requiring customers to purchase insurance from parent, subsidiary or affiliate of bank.
NRS 686A.090 Boycott, coercion or intimidation tending to result in unreasonable restraint of or monopoly in business of insurance prohibited.
NRS 686A.095 Cancellation or restriction of agent’s authority based solely on loss ratio experience prohibited in certain circumstances.
NRS 686A.100 Life insurance, annuities and health insurance: Unfair discrimination prohibited.
NRS 686A.110 Life insurance, annuities and health insurance: Rebates and other inducements prohibited; exceptions.
NRS 686A.120 Life insurance, annuities and health insurance: Exceptions to provisions limiting discrimination, rebates and use of securities as inducements.
NRS 686A.130 Property, casualty, surety and title insurance: Unfair discrimination and rebates prohibited; exceptions.
NRS 686A.135 Vision care: Prohibited provisions in contract between insurer and provider related to prescription of devices or materials in which insurer has pecuniary interest; insurer required to provide list of reimbursement rates to provider before entering contract; insurer required to disclose in policy pecuniary interest in supplier or provider; prohibited advertisements by insurer related to coverage.
NRS 686A.140 Violations concerning rebates and inducements: Penalties; effect.
NRS 686A.150 Using security, advisory board contract or agreement offering or promising profit as inducement prohibited.
NRS 686A.160 Enforcement: Prohibited methods, acts or practices.
NRS 686A.170 Enforcement: Undefined practices.
NRS 686A.180 Service of process upon unauthorized insurers.
NRS 686A.183 Cease and desist orders and penalties for prohibited methods, acts or practices; modification and setting aside of Commissioner’s orders.
NRS 686A.185 Review and finality of Commissioner’s orders.
NRS 686A.187 Penalties for violating cease and desist order.
NRS 686A.190 Interlocking ownership or management; serving as director of competing insurers.
NRS 686A.200 Plan or transaction involving favored agent or insurer prohibited; exception.
NRS 686A.210 Service and processing charges prohibited.
NRS 686A.220 Favored agent or surety for bonds or insurance contracts under public building or construction contract prohibited; exceptions; penalty.
NRS 686A.230 Illegal dealing in premiums; excess charges for insurance; regulations related to fees of broker, consultant or financial planner; written contract for consultation.
NRS 686A.240 Favoritism to groups prohibited; exceptions.
NRS 686A.250 Use of insurance or annuity as inducement for purchase or rental of property or services without separate charge prohibited; exceptions.
NRS 686A.260 Revocation or suspension of license for violation of laws of other state.
NRS 686A.270 Knowledge of insurer of prohibited acts required for violation.
NRS 686A.280 Use of name deceptively implying person is insurer prohibited by person who is not insurer.
NRS 686A.281 Definitions.
NRS 686A.2815 “Insurance fraud” defined.
NRS 686A.282 “Investigative or law enforcement agency” defined.
NRS 686A.2825 “Practitioner” defined.
NRS 686A.283 Reporting requirements; duties of Commissioner and Attorney General; prosecution by district attorney.
NRS 686A.285 Report by insurer of suspicion that loss to insured was caused by other than accidental or natural occurrence.
NRS 686A.287 Provision by insurer of information concerning fraud upon request by Attorney General, Commissioner or certain agencies.
NRS 686A.289 Provision to insurer of information concerning fraud upon completion of investigation or prosecution; confidentiality of information.
NRS 686A.290 Applications for insurance: False or fraudulent statements or representations prohibited; penalties.
NRS 686A.291 Criminal penalty for insurance fraud.
NRS 686A.292 Additional penalties for insurance fraud; payment of expenses of Fraud Control Unit; persons who are victims for purposes of restitution.
NRS 686A.295 Commissioner and Attorney General required to notify agency when person licensed by or registered with agency is convicted of insurance fraud.
NRS 686A.300 Delay in payment of claim for damages to motor vehicle after receipt of statement of charges prohibited; settling claim without providing for repair of vehicle permitted; exception.
NRS 686A.310 Unfair practices in settling claims; liability of insurer for damages.
NRS 686A.313 Required coordination by multiple insurers for certain dental claims; denial of claim prohibited; regulations.
NRS 686A.315 Statements required with certain billing and claim forms submitted to insurers; failure to provide statements not defense in prosecution for insurance fraud.
NRS 686A.325 Settlement of third-party liability claims: Written notice of payment to claimant required; effect of failure to serve notice.
FINANCING OF PREMIUMS
NRS 686A.330 Definitions.
NRS 686A.340 Engaging in business of company without license prohibited; exception.
NRS 686A.350 Exemptions from requirement of licensing.
NRS 686A.360 Application for license: Form; fees; bond; required documents; provision of material changes to Commissioner.
NRS 686A.370 True name and fictitious name of applicant or licensee; grounds for disapproval of name.
NRS 686A.380 Renewal of license.
NRS 686A.385 Schedule of rates and charges: Required to be filed with Commissioner for approval; filing of changes; inclusion in schedule required for imposition.
NRS 686A.390 Approval of forms.
NRS 686A.400 Records: Maintenance; form of preservation; open to Commissioner.
NRS 686A.410 Examination of company by Commissioner.
NRS 686A.420 Contents of agreement.
NRS 686A.430 Furnishing of completed copy of agreement to insured.
NRS 686A.440 Interest; service charge; prepayment.
NRS 686A.450 Permissible charges: Late payment; returned check; collection costs or attorney’s fees.
NRS 686A.460 Cancellation of insurance policy listed in agreement containing power of attorney enabling cancellation by company.
NRS 686A.470 Return of unearned premium and commission.
NRS 686A.480 Prohibited payments: Membership in motor club; policy of insurance covering accidental death or dismemberment.
NRS 686A.490 No recourse against agent based on insured’s default in payments; limitation on inducements; prohibited acts by company, agent or broker related to submission of agreement.
NRS 686A.500 Disclosure of financial interest required; agent or broker who submits or performs services in connection with agreement prohibited from receiving compensation.
NRS 686A.510 Penalties.
NRS 686A.520 Applicability of other provisions.
USE OF CONSUMER CREDIT INFORMATION
NRS 686A.600 Definitions.
NRS 686A.610 “Adverse action” defined.
NRS 686A.620 “Affiliate” defined.
NRS 686A.630 “Consumer credit report” defined.
NRS 686A.640 “Consumer reporting agency” defined.
NRS 686A.650 “Credit information” defined.
NRS 686A.660 “Insurance score” defined.
NRS 686A.670 Applicability.
NRS 686A.680 Consumer credit reports: Uses; limitations.
NRS 686A.685 Insurer that uses credit information to provide reasonable exceptions in certain circumstances.
NRS 686A.690 Reunderwriting or rerating of insured; refund of premium.
NRS 686A.700 Disclosure of use of credit information.
NRS 686A.710 Notice requirements after taking adverse action.
NRS 686A.720 Indemnification of agent by insurer.
NRS 686A.730 Consumer reporting agencies: Prohibitions; exemptions.
NRS 686A.010 Purpose. The purpose of NRS 686A.010 to 686A.310, inclusive, is to regulate trade practices in the business of insurance in accordance with the intent of Congress as expressed in the Act of Congress approved March 9, 1945, being c. 20, 59 Stat. 33, also designated as 15 U.S.C. §§ 1011 to 1015, inclusive, and Title V of Public Law 106-102, 15 U.S.C. §§ 6801 et seq.
1. Notwithstanding any other provision of law, the Commissioner has exclusive jurisdiction in regulating the subject of trade practices in the business of insurance in this state.
2. The Commissioner shall establish a program within the Division to investigate any act or practice which constitutes an unfair or deceptive trade practice in violation of the provisions of NRS 686A.010 to 686A.310, inclusive.
NRS 686A.020 Unfair methods of competition and unfair or deceptive acts or practices prohibited. A person shall not engage in this state in any practice which is defined in NRS 686A.010 to 686A.310, inclusive, as, or determined pursuant to NRS 686A.170 to be, an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.
1. Disclosure of nonpublic personal information in a manner contrary to the provisions of subchapter 1 of Title V of Public Law 106-102, 15 U.S.C. §§ 6801-6809 is an unfair act or practice in the business of insurance within the meaning of this chapter.
2. As used in this section, “nonpublic personal information” has the meaning ascribed to it in 15 U.S.C. § 6809(4).
3. The Commissioner shall adopt regulations necessary to carry out the provisions of this section.
(Added to NRS by 2001, 2214)
NRS 686A.027 Unfair or deceptive methods, acts or practices: Knowing access or use of contractual discount of provider of health care pursuant to provider network contract without applicable contractual relationship. It constitutes an unfair method of competition or an unfair or deceptive act or practice in the business of insurance to knowingly access or utilize a contractual discount of a provider of health care pursuant to a provider network contract without a contractual relationship with the provider of health care, health carrier or third party as specified in NRS 687B.693 to 687B.697, inclusive.
(Added to NRS by 2019, 1601)
NRS 686A.030 Misrepresentation and false or misleading advertising of policies prohibited. A person shall not make, issue, circulate or cause to be made, issued or circulated, any estimate, illustration, circular, statement, sales presentation or comparison which:
1. Misrepresents the benefits, advantages, conditions or terms of any insurance policy;
2. Misrepresents the dividends or share of the surplus to be received on any insurance policy;
3. Makes any false or misleading statement as to the dividends or share of surplus previously paid on any insurance policy;
4. Is misleading or is a misrepresentation as to the financial condition of any person, or as to the legal reserve system upon which any life insurer operates;
5. Uses any name or title of any policy or class of insurance policies misrepresenting the true nature thereof;
6. Is a misrepresentation for the purpose of inducing or tending to induce the lapse, forfeiture, exchange, conversion or surrender of any insurance policy;
7. Is a misrepresentation for the purpose of effecting a pledge or assignment of or effecting a loan against any insurance policy; or
8. Misrepresents any insurance policy as being shares of stock.
NRS 686A.040 False, deceptive or misleading information and advertising prohibited. No person shall make, publish, disseminate, circulate or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated or placed before the public, in a newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station, or in any other way, any advertisement, announcement or statement containing any assertion, representation or statement with respect to the business of insurance or with respect to any person in the conduct of his or her insurance business, which is untrue, deceptive or misleading.
(Added to NRS by 1971, 1688)
NRS 686A.050 “Twisting” prohibited. No person shall make or issue, or cause to be made or issued, any written or oral statement misrepresenting or making misleading comparison as to the terms, conditions, benefits or advantages of any insurance policy for the purpose of inducing, or attempting or tending to induce, any other person to lapse, forfeit, surrender, borrow against, retain, exchange, convert or otherwise deal with or dispose of any insurance policy.
(Added to NRS by 1971, 1688)
NRS 686A.055 Use of existence of Nevada Insurance Guaranty Association or Nevada Life and Health Insurance Guaranty Association to induce purchase of or discourage termination of insurance covered by Association prohibited; exception. A person who is an insurer or an agent or employee of an insurer shall not place before the public by any means any advertisement, announcement or statement which uses the existence of the Nevada Insurance Guaranty Association or the Nevada Life and Health Insurance Guaranty Association for the purpose of inducing the purchase of, or discouraging the termination of, any insurance covered by the Association. This section does not apply to either of the associations named.
NRS 686A.060 Replacement of life insurance: Statements required to be given to policyholder. In addition to other powers of the Commissioner in respect thereto, the Commissioner may by regulation require persons who replace or offer or propose to replace existing life insurance with other life insurance, to leave with the policyholder written, signed and dated statements which fully and accurately compare the terms, conditions and benefits of the existing policy with the proposed policy.
(Added to NRS by 1971, 1689)
1. A person subject to regulation under this Code shall not knowingly make or cause to be made any false entry of a material fact in any book, report or statement of any person or knowingly omit to make a true entry of any material fact pertaining to such person’s business in any book, report or statement of such person.
2. A person shall not knowingly file with any supervisory or other public officer, or knowingly make, publish, disseminate, circulate or deliver to any person, or place before the public, or knowingly cause directly or indirectly, to be made, published, disseminated, circulated, delivered to any person, or placed before the public, any false material statement of fact as to the financial condition of a person.
3. Any person who violates, or with like intent, aids or abets any violation of this section is guilty of a gross misdemeanor.
NRS 686A.080 Defamatory statement concerning person engaged or proposing to engage in business of insurance prohibited. No person shall make, publish, disseminate or circulate, directly or indirectly, or aid, abet or encourage the making, publishing, disseminating or circulating of any oral or written statement or any pamphlet, circular, article or literature which is false, or maliciously critical of or derogatory to an insurer, or of an organization proposing to become an insurer, and which is calculated to injure any person engaged or proposing to engage in the business of insurance.
(Added to NRS by 1971, 1689)
NRS 686A.085 Bank prohibited from requiring customers to purchase insurance from parent, subsidiary or affiliate of bank. A bank shall not in any manner extend credit, lease or sell property of any kind, or furnish any services, or fix or vary the consideration for any of them, on the condition or requirement that the customer purchase insurance from a parent, subsidiary or affiliate of the bank. For the purposes of this section, the terms “affiliate,” “parent” and “subsidiary” have the meanings ascribed to them in NRS 683A.231.
(Added to NRS by 1997, 782)
NRS 686A.090 Boycott, coercion or intimidation tending to result in unreasonable restraint of or monopoly in business of insurance prohibited. No person shall enter into any agreement to commit, or by any concerted action commit, any act of boycott, coercion or intimidation resulting in or tending to result in unreasonable restraint of, or any monopoly in, any business of insurance.
(Added to NRS by 1971, 1689)
1. An insurer shall not, without the written consent of the agent, cancel a written agreement with an agent or reduce or restrict the agent’s authority to transact property or casualty insurance based solely on the loss ratio experience on insurance transacted by that agent, if the agent was required to submit the applications for that insurance for underwriting approval, all material information on those applications was fully completed and the agent did not omit or alter any information provided by the applicants for that insurance.
2. As used in this section, “loss ratio experience” means the amount of money received by the insurer in payment of premiums divided by the amount of money expended by the insurer in payment of claims for a specified period.
(Added to NRS by 1989, 963)
1. No person may make or permit any unfair discrimination between persons of the same class and equal expectation of life in the rates charged for any contract of life insurance or of life annuity or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of such contract.
2. No person may make or permit any unfair discrimination between persons of the same class and of essentially the same hazard in the amount of premium, policy fees or rates charged for any policy or contract of health insurance or in the benefits payable thereunder, or in any of the terms or conditions of such contract, or in any other manner whatever.
3. No person may make or permit any unfair discrimination between persons legally qualified to provide a particular service, in the amount of the fee or charge for that service payable as a benefit under any policy or contract of health insurance.
1. Except as otherwise expressly provided by law, no person shall knowingly:
(a) Permit to be made or offer to make or make any contract of life insurance, life annuity or health insurance, or agreement as to such contract, other than as plainly expressed in the contract issued thereon, or pay or allow, or give or offer to pay, allow or give, directly or indirectly, or knowingly accept, as an inducement to such insurance or annuity, any rebate of premiums payable on the contract, or any special favor or advantage in the dividends or other benefits thereon, or any paid employment or contract for services of any kind, or any valuable consideration or inducement whatever not specified in the contract; or
(b) Directly or indirectly give or sell or purchase or offer or agree to give, sell, purchase, or allow as an inducement to such insurance or annuity or in connection therewith, whether or not to be specified in the policy or contract, any agreement of any form or nature promising returns and profits, or any stocks, bonds or other securities, or interest present or contingent therein or as measured thereby, of any insurer or other corporation, association or partnership, or any dividends or profits accrued or to accrue thereon.
2. The provisions of this section do not prohibit any person, in the case of any policy or contract of life insurance, life annuity or health insurance, from providing to a policyholder or prospective policyholder prizes and gifts, goods, wares, merchandise, gift certificates, donations made to charitable organizations, raffle entries, meals, event tickets and other items not to exceed $100 in aggregate value per policyholder or prospective policyholder in any 1 calendar year.
(a) In the case of any contract of life insurance or life annuity, paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from nonparticipating insurance, provided that any such bonuses or abatement of premiums shall be fair and equitable to policyholders and for the best interests of the insurer and its policyholders.
(b) In the case of life insurance policies issued on the debit plan, making allowance to policyholders who have continuously for a specified period made premium payments directly to an office of the insurer in an amount which fairly represents the saving in collection expense.
(c) Readjusting the rate of premium for a group insurance policy based on the loss or expense experience thereunder, at the end of the first or any subsequent policy year of insurance thereunder, which may be made retroactive only for such policy year.
(d) Reducing the premium rate for policies of large amounts, but not exceeding savings in issuance and administration expenses reasonably attributable to such policies as compared with policies of similar plan issued in smaller amounts.
(e) Reducing the premium rates for life or health insurance policies or annuity contracts on salary savings, payroll deduction, preauthorized check, bank draft or similar plans in amounts reasonably commensurate with the savings made by the use of such plans.
(f) Extending credit for the payment of any premium, and for which credit a reasonable rate of interest is charged and collected.
2. Nothing in NRS 686A.010 to 686A.310, inclusive, shall be construed as including within the definition of securities as inducements to purchase insurance the selling or offering for sale, contemporaneously with life insurance, of mutual fund shares or face amount certificates of regulated investment companies under offerings registered with the Securities and Exchange Commission where such shares or such face amount certificates or such insurance may be purchased independently of and not contingent upon purchase of the other, at the same price and upon similar terms and conditions as where purchased independently.
(Added to NRS by 1971, 1690)
1. Except as otherwise provided in subsection 2, no property, casualty, surety or title insurer or underwritten title company or any employee or representative thereof, and no broker, agent or solicitor may pay, allow or give, or offer to pay, allow or give, directly or indirectly, as an inducement to insurance, or after insurance has been effected, any rebate, discount, abatement, credit or reduction of the premium named in a policy of insurance, or any special favor or advantage in the dividends or other benefits to accrue thereon, or any valuable consideration or inducement whatever, not specified or provided for in the policy, except to the extent provided for in an applicable filing with the Commissioner.
2. The provisions of subsections 1 and 4 do not prohibit any property, casualty or surety insurer or any employee or representative thereof, or any broker, agent or solicitor from providing to an insured or prospective insured prizes and gifts, goods, wares, merchandise, gift certificates, donations made to charitable organizations, raffle entries, meals, event tickets and other items not to exceed $100 in aggregate value per insured or prospective insured in any 1 calendar year.
3. No title insurer or underwritten title company may:
(a) Pay, directly or indirectly, to the insured or any person acting as agent, representative, attorney or employee of the owner, lessee, mortgagee, existing or prospective, of the real property or interest therein which is the subject matter of title insurance or as to which a service is to be performed, any commission, rebate or part of its fee or charges or other consideration as inducement or compensation for the placing of any order for a title insurance policy or for performance of any escrow or other service by the insurer or underwritten title company with respect thereto; or
(b) Issue any policy or perform any service in connection with which it or any agent or other person has paid or contemplates paying any commission, rebate or inducement in violation of this section.
4. Except as otherwise provided in subsection 2, no insured named in a policy or any employee of that insured may knowingly receive or accept, directly or indirectly, any such rebate, discount, abatement, credit or reduction of premium, or any such special favor or advantage or valuable consideration or inducement.
5. No such insurer may make or permit any unfair discrimination between insured or property having like insuring or risk characteristics, in the premium or rates charged for insurance, or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of insurance.
6. No casualty insurer may make or permit any unfair discrimination between persons legally qualified to provide a particular service, in the amount of the fee or charge for that service payable as a benefit under any policy or contract of casualty insurance.
7. The provisions of this section do not prohibit:
(a) The payment of commissions or other compensation to licensed agents, brokers or solicitors.
(b) The extension of credit to an insured for the payment of any premium and for which credit a reasonable rate of interest is charged and collected.
(c) Any insurer from allowing or returning to its participating policyholders, members or subscribers, dividends, savings or unabsorbed premium deposits.
(d) With respect to title insurance, bulk rates or special rates for customers of prescribed classes if the bulk or special rates are provided for in the effective schedule of fees and charges of the title insurer or underwritten title company.
8. The provisions of this section do not apply to wet marine and transportation insurance.
NRS 686A.135 Vision care: Prohibited provisions in contract between insurer and provider related to prescription of devices or materials in which insurer has pecuniary interest; insurer required to provide list of reimbursement rates to provider before entering contract; insurer required to disclose in policy pecuniary interest in supplier or provider; prohibited advertisements by insurer related to coverage.
1. An insurer shall not enter into a contract with a provider of vision care that conditions any rate of reimbursement for vision care on the provider of vision care prescribing ophthalmic devices or materials in which the insurer has an ownership or other pecuniary interest or increases the rate of reimbursement if the provider of vision care prescribes such ophthalmic devices or materials.
2. Before entering into a contract with a provider of vision care to include the provider of vision care in the network of an insurer, the insurer must provide to the provider of vision care a list of the rates of reimbursement for each service covered by the contract.
3. An insurer shall disclose in any policy of insurance that covers vision care or any description of benefits covered by such a policy, whether written or electronic, any ownership or other pecuniary interest of the insurer in a supplier of ophthalmic devices or materials or a provider of vision care. The disclosure must appear in a conspicuous and clear manner.
4. An insurer that does not provide reimbursement for specific vision care shall not claim in any advertisement or other material that the insurer covers that vision care if such vision care is available at a discount or with a copayment or coinsurance in an amount that is in addition to the copayment or coinsurance that a covered person is typically required to pay for covered services.
5. As used in this section:
(a) “Provider of vision care” means a physician who provides vision care or an optometrist.
(b) “Vision care” means:
(1) Routine ophthalmological evaluation of the eye, including refraction.
(2) Ophthalmic devices or materials, including, without limitation, lenses, frames, mountings or other specially fabricated ophthalmic devices.
Ê The term “vision care” does not include the initiation of treatment or diagnosis pursuant to a program of medical care.
(Added to NRS by 2021, 899)
2. No agent or broker violating any of such provisions shall be entitled to receive any commission for the sale of any policy on which any rebate or inducement prohibited by NRS 686A.110 or 686A.130 has been given or offered, and the full amount of any commission so paid may be recovered by the insurer so paying.
3. The amount of any insurance upon which the insured has knowingly received or accepted, either directly or indirectly, any unlawful rebate of the premium or agent’s, solicitor’s or broker’s commission shall be reduced in such proportion as the amount or value of such rebate, commission or other consideration so received by the insured bears to the total premium on such policy.
4. A title insurer or underwritten title company shall be liable to the State of Nevada for five times the amount of any unlawful commission or rebate paid in violation of NRS 686A.130, which amount may be recovered by the Commissioner in addition to any other penalty imposed by law.
(Added to NRS by 1971, 1692)
NRS 686A.150 Using security, advisory board contract or agreement offering or promising profit as inducement prohibited. Except as provided in subsection 2 of NRS 686A.120 (contemporaneous sales of life insurance and mutual fund shares), no person shall sell, agree or offer to sell, or give or offer to give, directly or indirectly in any manner whatsoever, as an inducement to insurance or in connection therewith, any stock, shares, bonds or other securities of any kind, or any advisory board contract or other contract or agreement of any kind offering or promising returns and profits.
(Added to NRS by 1971, 1693)
NRS 686A.160 Enforcement: Prohibited methods, acts or practices. If the Commissioner has cause to believe that any person has been engaged or is engaging, in this state, in any unfair method of competition or any unfair or deceptive act or practice prohibited by NRS 686A.010 to 686A.310, inclusive, and that a proceeding by the Commissioner in respect thereto would be in the interest of the public, the Commissioner may issue and serve upon such person a statement of the charges and a notice of the hearing to be held thereon. The statement of charges and notice of hearing shall comply with the requirements of NRS 679B.320 and shall be served upon such person directly or by certified or registered mail, return receipt requested.
1. If the Commissioner believes that any person engaged in the insurance business is in the conduct of such business engaging in this state in any method of competition or in any act or practice not defined in NRS 686A.010 to 686A.310, inclusive, which is unfair or deceptive and that a proceeding by the Commissioner in respect thereto would be in the public interest, the Commissioner shall, after a hearing of which notice and of the charges against such person are given to the person, make a written report of the findings of fact relative to such charges and serve a copy thereof upon such person and any intervener at the hearing.
2. If such report charges a violation of NRS 686A.010 to 686A.310, inclusive, and if such method of competition, act or practice has not been discontinued, the Commissioner may, through the Attorney General, at any time after 20 days after the service of such report cause an action to be instituted in the district court of the county wherein the person resides or has his or her principal place of business to enjoin and restrain such person from engaging in such method, act or practice. The court shall have jurisdiction of the proceeding and shall have power to make and enter appropriate orders in connection therewith and to issue such writs or orders as are ancillary to its jurisdiction or necessary in its judgment to prevent injury to the public pendente lite; but the State of Nevada shall not be required to give security before the issuance of any such order or injunction under this section. If a stenographic record of the proceedings in the hearing before the Commissioner was made, a certified transcript thereof including all evidence taken and the report and findings shall be received in evidence in such action.
3. If the court finds that:
(a) The method of competition complained of is unfair or deceptive;
(b) The proceedings by the Commissioner with respect thereto are to the interest of the public; and
(c) The findings of the Commissioner are supported by the weight of the evidence,
Ê it shall issue its order enjoining and restraining the continuance of such method of competition, act or practice.
4. Either party may appeal from such final judgment or order or decree of court in a like manner as provided for appeals in civil cases.
5. If the Commissioner’s report made under subsection 1 or order on hearing made under NRS 679B.360 does not charge a violation of NRS 686A.010 to 686A.310, inclusive, then any intervener in the proceedings may appeal therefrom within the time and in the manner provided in this Code for appeals from the Commissioner generally.
6. Upon violation of any injunction issued under this section, the Commissioner, after a hearing thereon, may impose the appropriate penalties provided for in NRS 686A.187.
1. Service of all process, statements of charges and notices under NRS 686A.010 to 686A.310, inclusive, upon unauthorized insurers shall be made by delivering to and leaving with the Commissioner or some person in apparent charge of the office of the Commissioner two copies thereof, or in the manner provided for by subsection 2 of NRS 685B.050 (service of process).
2. The Commissioner shall forward all such process, statements of charges and notices to the insurer in the manner provided in subsection 3 of NRS 685B.050.
3. No default shall be taken against any such unauthorized insurer until expiration of 30 days after the date of forwarding by the Commissioner under subsection 2, or date of service of process if under subsection 2 of NRS 685B.050.
4. NRS 685B.050 applies to all process, statements of charges and notices under this section.
(Added to NRS by 1971, 1694)
1. After the hearing provided for in NRS 686A.160, the Commissioner shall issue an order on hearing pursuant to NRS 679B.360. If the Commissioner determines that the person charged has engaged in an unfair method of competition or an unfair or deceptive act or practice in violation of NRS 686A.010 to 686A.310, inclusive, the Commissioner shall order the person to cease and desist from engaging in that method of competition, act or practice, and may order one or both of the following:
(a) If the person knew or reasonably should have known that he or she was in violation of NRS 686A.010 to 686A.310, inclusive, payment of an administrative fine of not more than $5,000 for each act or violation, except that as to licensed agents, brokers, solicitors and adjusters, the administrative fine must not exceed $500 for each act or violation.
2. Until the expiration of the time allowed for taking an appeal, pursuant to NRS 679B.370, if no petition for review has been filed within that time, or, if a petition for review has been filed within that time, until the official record in the proceeding has been filed with the court, the Commissioner may, at any time, upon such notice and in such manner as the Commissioner deems proper, modify or set aside, in whole or in part, any order issued by him or her under this section.
3. After the expiration of the time allowed for taking an appeal, if no petition for review has been filed, the Commissioner may at any time, after notice and opportunity for hearing, reopen and alter, modify or set aside, in whole or in part, any order issued by him or her under this section whenever in the opinion of the Commissioner conditions of fact or of law have so changed as to require such action or if the public interest so requires.
(a) Upon the expiration of the time allowed for taking an appeal, if no petition for review has been duly filed within such time, except that the Commissioner may thereafter modify or set aside the order to the extent provided in subsection 3 of NRS 686A.183; or
(b) Upon the final decision of the court if the court directs that the order of the Commissioner be affirmed or the petition for review dismissed.
(Added to NRS by 1975, 1285)
NRS 686A.187 Penalties for violating cease and desist order. Any person who violates a cease and desist order of the Commissioner issued under NRS 686A.183, except one issued with respect to NRS 686A.170, is subject, in the discretion of the Commissioner, after notice and hearing and upon order of the Commissioner, to one or both of the following:
1. Payment of an administrative fine of not more than $5,000 for each and every violation.
2. Suspension or revocation of the license.
(Added to NRS by 1975, 1285)
1. Any insurer may retain, invest in or acquire the whole or any part of the capital stock of any other insurer or insurers, or have a common management with any other insurer or insurers, unless such retention, investment, acquisition or common management is inconsistent with any other provision of this Code, or unless by reason thereof the business of such insurers with the public is conducted in a manner which substantially lessens competition generally in the insurance business or tends to create any monopoly therein.
2. Any person otherwise qualified may be a director of two or more insurers which are competitors, unless the effect thereof is to lessen substantially competition between insurers generally or tends materially to create any monopoly.
(Added to NRS by 1971, 1694)
1. Except as otherwise provided in NRS 616B.710, no person shall require, directly or indirectly, or through any trustee, director, officer, agent or employee or affiliate, as a condition, agreement or understanding to selling or furnishing any other person any loan, or extension thereof, credit, sale, goods, property, contract, lease or service, that such other person shall place, continue (other than as to life insurance) or renew any policy of insurance of any kind through any particular agent, broker or insurer. No agent, broker or insurer shall knowingly participate in any such prohibited plan or transaction. No person shall fix a price charged for such thing or service, or discount from or rebate upon price, on the condition, agreement or understanding that any insurance is to be obtained through a particular agent, broker or insurer.
2. Subsection 1 does not prevent:
(a) The exercise by any such person upon a reasonable basis of any right to approve or disapprove of the insurer and representative to underwrite the insurance. Such basis shall relate only to the adequacy and terms of the coverage with respect to the interest of the vendor, lender, lessor or provider of service to be insured thereunder, the financial standards to be met by the insurer, and the ability of the insurer or representative to service the policy.
(b) The exercise by the vendor, lender, lessor or provider of service of the right to furnish or renew the insurance, and to charge the account of the other person with the costs thereof, if such other person fails to deliver such insurance to the lender, vendor, lessor or provider of service, where otherwise called for and in order, at least 15 days prior to expiration of the existing policy.
NRS 686A.210 Service and processing charges prohibited. No mortgagee, lessor, vendor or other person whose interest is insured under an insurance policy paid for by another shall make, receive or accept any monetary charge or fee paid or payable by such other person, for handling, servicing or processing the insurance policy, or endorsements thereon or cancellation thereof.
(Added to NRS by 1971, 1696)
1. Except as otherwise provided in NRS 616B.710, no officer or employee of this state, or of any public agency, public authority or public corporation (except a public corporation or public authority created pursuant to agreement or compact with another state), and no person acting or purporting to act on behalf of such officer or employee, or public agency or public authority or public corporation, shall, with respect to any public building or construction contract which is about to be or which has been competitively bid, require the bidder to make application or furnish financial data to, or to obtain or procure any of the surety bonds or contracts of insurance specified in connection with such contracts or by any law from, a particular insurer or agent or broker.
2. Except as otherwise provided in NRS 616B.710, no such officer or employee or any person acting or purporting to act on behalf of such officer or employee shall negotiate, make application for, obtain or procure any of such surety bonds or contracts of insurance (except contracts of insurance for builder’s risk or owner’s protective liability) which can be obtained or procured by the bidder, contractor or subcontractor.
3. This section does not, however, prevent the exercise by such officer or employee on behalf of the State or such public agency, public authority or public corporation of its right to approve the form, sufficiency or manner of execution of the surety bonds or contracts of insurance furnished by the insurer selected by the bidder to underwrite such bonds or contracts of insurance.
4. Any provisions in any invitation for bids or in any of the contract documents in conflict with this section are declared to be contrary to the public policy of this state.
5. A violation of this section is subject to the penalties provided by NRS 679A.180 (general penalty).
1. A person shall not willfully collect any sum as a premium or charge for insurance which is not then provided or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an insurance policy issued by an insurer as authorized by this Code.
2. Except as otherwise provided in subsection 3, a person shall not willfully collect as a premium or charge for insurance any sum in excess of the premium or charge applicable to the insurance and as specified in the policy, in accordance with the applicable classifications and rates as filed with and approved by the Commissioner. In cases where classifications, premiums or rates are not required by this Code to be so filed and approved, the premiums and charges must not be in excess of those specified in the policy and as fixed by the insurer. This subsection does not prohibit:
(b) The charging and collection by a life insurer of amounts actually to be expended for the medical examination of any applicant for life insurance or for reinstatement of a life insurance policy.
3. The Commissioner may adopt regulations to allow the charging and collection of a fee by an insurance broker, consultant or financial planner:
(a) In lieu of any other charge or commission for solicitation, negotiation or procurement of a policy of insurance which covers commercial or business risks;
(b) For consultation or any related advice on the insuring of commercial or business risks which does not result in the procurement of a policy of insurance; and
(c) For consultation or related advice on the purchase of individual or group life or health insurance or an individual or group annuity, whether or not it results in the purchase of a policy of insurance or annuity. In such a case, the fee must be set forth in a written contract signed by the client before the consultation begins.
4. An agent or broker who provides consultation or related advice pursuant to this section shall do so pursuant to a written contract specifying the compensation the agent or broker will receive. The compensation may be in addition to or in lieu of a commission and is not a premium as defined in NRS 679A.115.
1. No form or plan of insurance covering any group or combination of persons or risks shall be written or delivered within or outside this state to cover persons or risks in this state at any preferred rate or on any form other than as offered to persons not in such group or combination and to the public generally, unless such form, plan of insurance, and the rates or premiums to be charged therefor have been submitted to and approved by the Commissioner.
2. Any such plan of insurance described in subsection 1 shall not be approved by the Commissioner unless it is made available to all individuals of the group who seek to be insured. No insurer or agent shall deny coverage to any individual of such group who seeks the type of insurance which is being made available to other members of the group.
3. This section does not apply to life insurance, health insurance, annuity contracts or wet marine and transportation insurance.
(Added to NRS by 1971, 1942)
1. No person shall arrange, provide or participate in any plan to offer or effect any kind or kinds of insurance or annuities in this state as an inducement to the purchase or rental by the public of any property or services, without a separate charge to the insured for such insurance.
2. This section does not apply to:
(a) Insurance written in connection with a subscription to newspapers of general circulation;
(b) Insurance issued to credit unions or members thereof in connection with the purchase of shares in such credit union;
(c) Insurance offered as guarantee to the performance of goods and designed to protect the purchasers or users of such goods;
(d) Title insurance;
(e) Life or health insurance written in connection with an indebtedness for the purpose of paying the balance of the indebtedness on death or disability of the individual insured; or
(f) Services provided by motor clubs.
(Added to NRS by 1971, 1696)
NRS 686A.260 Revocation or suspension of license for violation of laws of other state. The Commissioner may revoke or suspend the license of any person domiciled or resident in Nevada and licensed to transact insurance in Nevada as insurer, agent, broker or otherwise, upon a hearing and proof that such person, as the result of a hearing before the commissioner, director or superintendent of insurance or insurance department of another state, or in a judicial proceeding in another state, has been found to have violated the insurance laws of that state relating to unfair methods of competition or unfair or deceptive acts or practices in the conduct of the business of insurance, and as a result thereof either has had his or her license revoked or suspended in that state or has been found guilty of failing to comply with any order, decree or judgment issued pursuant to such hearing or judicial proceeding in that state.
(Added to NRS by 1971, 1697)
NRS 686A.270 Knowledge of insurer of prohibited acts required for violation. No insurer shall be held guilty of having committed any of the acts prohibited by NRS 686A.010 to 686A.310, inclusive, by reason of the act of any agent, solicitor or employee not an officer, director or department head thereof, unless an officer, director or department head of the insurer has knowingly permitted such act or has had prior knowledge thereof.
(Added to NRS by 1971, 1697)
NRS 686A.280 Use of name deceptively implying person is insurer prohibited by person who is not insurer. No person who is not an insurer shall assume or use any name which deceptively implies or suggests that it is an insurer.
(Added to NRS by 1971, 1697)
NRS 686A.281 Definitions. As used in NRS 686A.281 to 686A.295, inclusive, unless the context otherwise requires, the words and terms defined in NRS 686A.2815, 686A.282 and 686A.2825 have the meanings ascribed to them in those sections.
1. “Insurance fraud” means knowingly and willfully:
(a) Presenting or causing to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits facts, or contains false or misleading information concerning any fact material to an application for the issuance of a policy of insurance.
(b) Presenting or causing to be presented any statement as a part of, or in support of, a claim for payment or other benefits under a policy of insurance, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits facts, or contains false or misleading information concerning any fact material to that claim.
(c) Assisting, abetting, soliciting or conspiring with another person to present or cause to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who assists, abets, solicits or conspires knows that the statement conceals or omits facts, or contains false or misleading information concerning any fact material to an application for the issuance of a policy of insurance or a claim for payment or other benefits under such a policy.
(d) Acting or failing to act with the intent of defrauding or deceiving an insurer, a reinsurer, a producer, a broker or any agent thereof, to obtain a policy of insurance or any proceeds or other benefits under such a policy.
(e) As a practitioner, an insurer or any agent thereof, acting to assist, conspire with or urge another person to commit any act or omission specified in this section through deceit, misrepresentation or other fraudulent means.
(f) Accepting any proceeds or other benefits under a policy of insurance, if the person who accepts the proceeds or other benefits knows that the proceeds or other benefits are derived from any act or omission specified in this section.
(g) Employing a person to procure clients, patients or other persons who obtain services or benefits under a policy of insurance for the purpose of engaging in any act or omission specified in this section, except that such insurance fraud does not include contact or communication by an insurer or an agent or representative of the insurer with a client, patient or other person if the contact or communication is made for a lawful purpose, including, without limitation, communication by an insurer with a holder of a policy of insurance issued by the insurer or with a claimant concerning the settlement of any claims against the policy.
(h) Participating in, aiding, abetting, conspiring to commit, soliciting another person to commit, or permitting an employee or agent to commit any act or omission specified in this section.
2. As used in this section, “policy of insurance” means:
(a) Any policy issued in this State by an authorized insurer; and
(b) Any policy issued outside this State by an authorized insurer which relates to property that:
(1) Is located in this State when any act or omission specified in this section occurs; or
(2) Was located in this State when the incident that gave rise to the act or omission specified in this section occurred.
1. The State Fire Marshal;
2. The chief or other officer of the fire department in whose jurisdiction a fire has occurred;
3. The district attorney of the county where any fraudulent activity has occurred or where a fraudulent claim has been made; and
4. Any other officer of an agency in this state who has the authority to investigate the fraudulent activity or claim.
(Added to NRS by 2001, 1096)
1. A physician, dentist, nurse, dispensing optician, optometrist, physical therapist, podiatric physician, psychologist, chiropractic physician, doctor of Oriental medicine in any form, director or technician of a medical laboratory, pharmacist, person who holds a license to engage in radiation therapy and radiologic imaging or a limited license to engage in radiologic imaging pursuant to chapter 653 of NRS or other provider of health services who is authorized to engage in his or her occupation by the laws of this state or another state; and
2. An attorney admitted to practice law in this state or any other state.
1. Any person, governmental entity, insurer or authorized representative of an insurer shall report any information concerning insurance fraud to the Commissioner and Attorney General on a form prescribed by the Commissioner and Attorney General.
2. The Commissioner and Attorney General shall each independently:
(a) Review each report of insurance fraud; and
(b) Determine whether an investigation should be made of the facts in the report.
3. During their respective investigations, the Commissioner and Attorney General shall independently determine whether there is probable cause to believe that insurance fraud has occurred.
4. A district attorney of any county where fraudulent activity has occurred or is occurring or where a fraudulent claim that would constitute insurance fraud has been made may, with the permission of the Attorney General or at the request of the Attorney General, institute proceedings in the name of the State of Nevada.
1. If an insurer has a reasonable suspicion that a loss to an insured may have been caused by other than an accidental or a natural occurrence, the insurer shall notify the Commissioner and Attorney General in writing of the insurer’s reasons for the suspicion.
2. Any insurer making such a report shall provide the Commissioner and Attorney General with any information the insurer obtained during its investigation of the claim.
3. If the loss referred to in subsection 1 is believed to be caused by fire, the insurer shall also so notify an investigative or law enforcement agency.
1. Every insurer shall provide information concerning insurance fraud to the Attorney General, the Commissioner, any investigative or law enforcement agency or any agency of the Federal Government, if the insurer receives a request in writing for that information.
2. The information requested from an insurer may include:
(a) Information about the policy of insurance on the property which was demolished or destroyed, including information from the application for insurance;
(b) Information on previous claims made by the insured;
(c) Records of the premiums paid for the policy of insurance; and
(d) Information concerning the insurer’s investigation of the claim, including statements of any person, information submitted as proof of the loss or any other relevant information on the claim.
1. Any insurer giving information to the Attorney General, the Commissioner or any investigative or law enforcement agency concerning an act or omission alleged to be insurance fraud is entitled to receive, upon completion of the investigation or prosecution of the insurance fraud, whichever occurs later, any relevant information concerning the fraudulent activity.
2. The Attorney General, the Commissioner or any investigative or law enforcement agency receiving information from another person, agency or insurer shall:
(a) Keep the information confidential and not release the information except pursuant to subsection 1 and NRS 239.0115;
(b) Provide information concerning its investigation of the insurance fraud to the insurer reporting the fraudulent activity upon the completion of its investigation or a criminal prosecution, whichever occurs later; and
(c) Provide any documents necessary or allow its employees or agents to testify in any action by or against the insurer if the insurer or its insured furnished the information for the investigation or a criminal prosecution.
1. A producer of insurance, examining physician, applicant or other person shall not knowingly or willfully make any false or fraudulent statement or representation in or with reference to any application for insurance.
2. A person who violates this section is guilty of a category D felony and shall be punished as provided in NRS 193.130. In addition to any other penalty, the court shall order the person to pay restitution.
NRS 686A.291 Criminal penalty for insurance fraud. A person who commits insurance fraud is guilty of a category D felony and shall be punished as provided in NRS 193.130.
1. A court may, in addition to imposing the penalties set forth in NRS 193.130, order a person who is convicted of, or who pleads guilty, guilty but mentally ill or nolo contendere to, insurance fraud to pay:
(a) Court costs; and
(b) The cost of the investigation and prosecution of the insurance fraud for which the person was convicted or to which the person pleaded guilty, guilty but mentally ill or nolo contendere.
2. Any money received by the Attorney General pursuant to paragraph (b) of subsection 1 must be accounted for separately and used to pay the expenses of the Fraud Control Unit for Insurance established pursuant to NRS 228.412, and is hereby authorized for expenditure for that purpose. The money in the account does not revert to the State General Fund at the end of any fiscal year and must be carried forward to the next fiscal year.
3. An insurer or other organization, or any other person, subject to the jurisdiction of the Commissioner pursuant to this title shall be deemed to be a victim for the purposes of restitution in a case that involves insurance fraud or that is related to a claim of insurance fraud.
NRS 686A.295 Commissioner and Attorney General required to notify agency when person licensed by or registered with agency is convicted of insurance fraud. If a person who is licensed or registered under the laws of the State of Nevada to engage in a business or profession is convicted of, or pleads guilty or guilty but mentally ill to, engaging in an act of insurance fraud, the Commissioner and the Attorney General shall forward to each agency by which the convicted person is licensed or registered a copy of the conviction or plea and all supporting evidence of the act of insurance fraud.
1. An insurer who issues insurance covering damage to a motor vehicle shall not delay making payment for any claim involving damage to a motor vehicle after receiving a statement of charges, pursuant to the provisions of NRS 487.6893, from any garage or licensed body shop previously authorized by the insured to perform the repairs required by that claim.
2. A delay, within the meaning of this section, is failure to issue a check or draft, payable to the garage or licensed body shop or jointly to the insured and the garage or licensed body shop, within 30 days after the insurer’s receipt of the statement of charges for repairs which have been satisfactorily completed.
3. If the damaged vehicle is subject to a security interest or the legal owner of the damaged vehicle is different from the registered owner, the vehicle must be repaired by a garage or licensed body shop unless:
(a) The insurer has declared the vehicle a total loss; or
(b) The total charge for the repair of the vehicle, as set forth in the statement of charges presented pursuant to NRS 487.6893, is $300 or less.
4. Except as otherwise provided in subsection 3, nothing in this section shall be deemed to prohibit an insurer and insured from settling a claim involving damage to a motor vehicle without providing for the repair of the vehicle.
5. As used in this section, “licensed body shop” means a body shop for which a license has been issued pursuant to chapter 487 of NRS.
1. Engaging in any of the following activities is considered to be an unfair practice:
(a) Misrepresenting to insureds or claimants pertinent facts or insurance policy provisions relating to any coverage at issue.
(b) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies.
(c) Failing to adopt and implement reasonable standards for the prompt investigation and processing of claims arising under insurance policies.
(d) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss requirements have been completed and submitted by the insured.
(e) Failing to effectuate prompt, fair and equitable settlements of claims in which liability of the insurer has become reasonably clear.
(f) Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds, when the insureds have made claims for amounts reasonably similar to the amounts ultimately recovered.
(g) Attempting to settle a claim by an insured for less than the amount to which a reasonable person would have believed he or she was entitled by reference to written or printed advertising material accompanying or made part of an application.
(h) Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of, the insured, or the representative, agent or broker of the insured.
(i) Failing, upon payment of a claim, to inform insureds or beneficiaries of the coverage under which payment is made.
(j) Making known to insureds or claimants a practice of the insurer of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration.
(k) Delaying the investigation or payment of claims by requiring an insured or a claimant, or the physician of either, to submit a preliminary claim report, and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information.
(l) Failing to settle claims promptly, where liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
(n) Failing to provide promptly to an insured a reasonable explanation of the basis in the insurance policy, with respect to the facts of the insured’s claim and the applicable law, for the denial of the claim or for an offer to settle or compromise the claim.
(o) Advising an insured or claimant not to seek legal counsel.
(p) Misleading an insured or claimant concerning any applicable statute of limitations.
2. In addition to any rights or remedies available to the Commissioner, an insurer is liable to its insured for any damages sustained by the insured as a result of the commission of any act set forth in subsection 1 as an unfair practice.
1. The following provisions apply to a claim for payment submitted for services provided by an oral and maxillofacial surgeon which may be covered, in whole or in part, by a stand-alone dental benefit and a policy of health insurance:
(a) If a claimant is covered by a stand-alone dental benefit and a policy of health insurance, the stand-alone dental benefit is the primary policy and the claim must be first submitted to the health insurer that issued the stand-alone dental benefit. The issuer of the secondary policy may not reduce benefits based upon payments under the primary policy, except to avoid overpayment to the oral and maxillofacial surgeon.
(b) Except as otherwise provided in paragraph (a), a health insurer may not deny a claim for which it has liability solely on the basis that another health insurer has liability to pay the claim.
2. The Commissioner may adopt regulations necessary to carry out the provisions of this section.
3. As used in this section:
(a) “Oral and maxillofacial surgeon” means a dentist who has been issued a specialist’s license to practice oral and maxillofacial surgery pursuant to NRS 631.250 and who provides any of the services described in paragraph (c) of subsection 1 of NRS 631.215.
(b) “Stand-alone dental benefit” means any policy which only pays for or reimburses any part of the cost of dental care, as defined in NRS 695D.030, and is offered or issued separately from any policy of health insurance.
(Added to NRS by 2015, 2120)
1. If a hospital submits to an insurer the form prescribed by the Director of the Department of Health and Human Services pursuant to NRS 449.485, that form must contain or be accompanied by a statement that reads substantially as follows:
Any person who misrepresents or falsifies essential information requested on this form may, upon conviction, be subject to a fine and imprisonment under state or federal law, or both.
2. If a person who is licensed to practice one of the health professions regulated by title 54 of NRS submits to an insurer the form commonly referred to as the “HCFA-1500” for a patient who is not covered by any governmental program which offers insurance coverage for health care, the form must be accompanied by a statement that reads substantially as follows:
Any person who knowingly files a statement of claim containing any misrepresentation or any false, incomplete or misleading information may be guilty of a criminal act punishable under state or federal law, or both, and may be subject to civil penalties.
3. The failure to provide any of the statements required by this section is not a defense in a prosecution for insurance fraud pursuant to NRS 686A.291.
1. In any third-party liability claim, an insurer shall not issue a check or draft or otherwise make payment of $5,000 or more in settlement of the claim to a representative of the claimant, including, without limitation, the lawyer for the claimant, unless the insurer, at the time of making the payment or as soon as practicable thereafter, mails written notice of the payment to the claimant at the last known address of the claimant.
2. The failure of an insurer to serve notice as required by subsection 1 or defective service of the notice does not:
(a) Create, and must not be construed to create, a cause of action for any natural person or entity other than the Commissioner.
(b) Establish, and must not be construed to establish, a defense for any party to any cause of action.
3. As used in this section, “third-party liability claim” means a claim brought under a liability insurance policy by a person other than the insured, where the claimant is a natural person.
(Added to NRS by 2005, 1001)
FINANCING OF PREMIUMS
1. “Agreement” means a contract between a person and an insured or prospective insured under which the person agrees to pay a premium in advance on behalf of the insured or prospective insured in exchange for repayment of the amount advanced with interest or for some other consideration.
2. “Company” means a person engaged in the business of entering into agreements or purchasing agreements. The term does not include a person who finances a premium in connection with the sale of a motor vehicle upon which the person holds a lien.
NRS 686A.335 Applicability of chapter 696B of NRS.
1. A company is subject to the provisions of chapter 696B of NRS.
2. For the purposes of chapter 696B of NRS, a company shall be deemed to be an insurer.
(Added to NRS by 1995, 1621)
NRS 686A.340 Engaging in business of company without license prohibited; exception. Except as provided in NRS 686A.350, a person shall not engage in the business of a company or hold himself or herself out as a company without first having received a license from the Commissioner to engage in the business of a company.
(Added to NRS by 1985, 1154)
1. A license to engage in the business of a company is not required of any:
(a) State or federally chartered building association, savings and loan association or savings bank.
(b) State or federally chartered bank.
(c) State or federally chartered credit union.
(d) Thrift company licensed pursuant to chapter 677 of NRS.
(e) Producer of insurance financing his or her own accounts.
(f) Insurer authorized to do business in this state financing its own policies or those of an affiliated company.
(g) Business, in addition to those included in paragraphs (a) to (d), inclusive, which is licensed and regulated by the Division of Financial Institutions of the Department of Business and Industry.
1. An application for a license to engage in the business of a company must be filed with the Commissioner on a form prescribed by the Commissioner and must include:
(a) A nonrefundable fee for application and for investigation of the applicant of $500 and, in addition to any other fee or charge, all applicable fees required pursuant to NRS 680C.110;
(b) A surety bond which complies with NRS 679B.175 and is in an amount determined by the Commissioner;
(c) A current certified financial statement or another financial statement if individually approved by the Commissioner;
(d) An appointment of the Commissioner and the successors in office of the Commissioner as the applicant’s attorney to receive service of process; and
(e) If the applicant is a corporation, a copy of its articles of incorporation.
2. The applicant shall provide the Commissioner with any material change concerning information contained in the application within 10 days after the change occurs.
1. An unincorporated licensee or unincorporated applicant for a license who desires the issuance of a license under a fictitious name must file with the Commissioner a certified copy of the entry in the county clerk’s register and of the certificate or any renewal certificate filed pursuant to chapter 602 of NRS. An incorporated licensee and incorporated applicant must file with the Commissioner in writing the corporation’s true name and the fictitious names under which it conducts or intends to conduct business in this state. After licensing, each licensee shall file promptly with the Commissioner written notice of any change in or discontinuance of any fictitious name.
2. The Commissioner may in writing disapprove the use of any true name, other than the bona fide natural name of a natural person, or any fictitious name used or proposed to be used by any applicant or licensee, on any of the following grounds:
(a) The name interferes with or is deceptively similar to a name already filed and in use by another licensee;
(b) Use of the name may mislead the public in any respect; or
(c) The name states or implies that the licensee or applicant is an insurer or is entitled to engage in insurance activities not authorized under the licenses which the licensee holds or for which the applicant has applied.
1. A company must renew its license on or before March 1 of each year. An application for renewal must be submitted on a form prescribed by the Commissioner and must be accompanied by:
(a) A financial statement for the preceding year; and
(b) A fee of $500, any penalty imposed pursuant to subsection 2 and, in addition to any other fee or charge, all applicable fees required pursuant to NRS 680C.110.
2. The Commissioner may grant an extension allowing a company to file an application for renewal after March 1 if the company shows that for reasons beyond its control it cannot apply before that date. If a company which has not been granted an extension files its application for renewal after March 1, the company shall pay a penalty of $25 for each day the application is late.
1. A company shall, immediately after it has been issued a license, file with the Commissioner a schedule of rates and charges it intends to use in this state. The schedule must include, and separately identify, any commission which is required to be paid to an agent or broker who completes an agreement. Any change in the schedule must be filed with the Commissioner at least 60 days before the rates become effective.
2. A company may not impose a charge included in an agreement unless the charge is included in the schedule filed with the Commissioner.
3. The Commissioner shall not approve any charge listed in the schedule which is unfairly discriminatory in relation to similar risks.
(Added to NRS by 1993, 2393)
1. Before using a form for an agreement or notice required by this chapter, a company must submit the proposed form to the Commissioner for approval. If the Commissioner does not disapprove a form within 60 days after it is submitted, the form shall be deemed approved.
3. An insurer, including any subsidiary of an insurer or corporation under substantially the same management or control as an insurer, shall file all forms for agreements and any related forms. The filing required in this subsection is in addition to the filings required pursuant to chapter 686B of NRS.
1. A company shall maintain records of each transaction for 3 years after making the final entry with respect to the transaction. The records may be preserved in photographic form, on microfilm or microfiche or in a form approved by the Commissioner.
2. The records must be open to the Commissioner at all times. The Commissioner may require a company to furnish to the Commissioner in any form the Commissioner requires any information maintained in the company’s records.
(Added to NRS by 1985, 1155)
NRS 686A.410 Examination of company by Commissioner. The Commissioner may conduct an examination of a company at any time in accordance with NRS 679B.250 to 679B.287, inclusive. The expense of the examination must be borne by the company in accordance with NRS 679B.290 as if the company were an insurer.
1. An agreement executed in this state must be dated and signed by the insured. The printed portion of the agreement must be in not less than 8-point type. The agreement must include:
(a) The name and the address and telephone number of the business of the producer of insurance for the insurance contract to which the agreement relates;
(b) The name and the address of the business or residence of the insured;
(c) The name, address and telephone number of the company to which payments must be made;
(d) A brief description of any insurance policy involved; and
(e) Such other information as may be required by the Commissioner.
2. An agreement must have at its top in type which is more prominent than the text of the agreement, the words “Agreement For Financing Premium” or words of similar meaning. An agreement must contain a notice in type which is more prominent than the text of the agreement which reads as follows:
1. Do not sign this agreement before you have read it or if it contains any blank spaces.
2. You are entitled to a copy of this agreement which is complete.
NRS 686A.430 Furnishing of completed copy of agreement to insured. The agent, broker or other person preparing an agreement shall furnish a completed copy of the agreement to the insured immediately after the insured signs the agreement.
(Added to NRS by 1985, 1156)
1. A company shall not charge or collect a charge for interest which is not permitted by this section.
2. Interest must be computed on the balance due, after subtracting the down payment, from the effective date of the insurance contract or agreement, whichever is earlier, through the date on which the final installment is payable.
3. The rate of interest must be specified in the agreement. The agreement may provide for a service charge of not more than $25, and that the charge is not refundable.
4. An insured may prepay in full at any time the unpaid balance of the principal. The insured is entitled to a refund of the unearned portion of the prepaid interest. The refund must be at least as great a proportion of the prepaid interest as the sum of the periodic balances for each period beginning one period after the prepayment is made bears to the sum of all the periodic balances under the schedule of payments in the agreement. If the amount of the refund is less than $1, no refund need be made.
5. Any provision which purports to limit the insured’s right of prepayment pursuant to this section is void.
(Added to NRS by 1985, 1156)
1. A company shall not impose or collect a fee or charge which is not authorized by this section.
2. An agreement may provide for a charge for any late payment of an installment of not less than $1 and not more than 5 percent of the installment.
3. A company may collect a fee of not more than $15 for each check returned to the company because the insured had insufficient money or credit with the drawee to pay the check or because the insured stopped payment on the check.
4. An agreement may provide for payment of collection costs or attorney’s fees, equal to 20 percent of the outstanding indebtedness if the agreement is referred for collection to a collection agency or attorney who is not an employee of the company.
1. When an agreement contains a power of attorney enabling the company, in the name of the insured, to cancel any insurance policy listed in the agreement, the insurance policy must not be cancelled by the company unless it is cancelled in accordance with this section.
2. A company shall mail written notice of its intent to cancel an insurance policy because of a default in payment under an agreement to the insured at the last known address of the insured as indicated in the records of the company and to the agent who submitted the agreement at least 10 days before the cancellation. If the default is cured within this 10-day period, the company shall not cancel the insurance policy.
3. If the default is not cured within the 10-day period, the company may cancel the policy if it mails to the insured at the last known address of the insured as indicated in the records of the company and to the insurer a notice of cancellation which must include the effective date of cancellation. The policy must be cancelled as if the notice of cancellation had been submitted by the insured, but without requiring the return of the policy.
4. No insurance policy may be cancelled for nonpayment of a charge for a late payment.
5. This section does not authorize the cancellation of an insurance policy without giving any other notice required by law or satisfying other conditions for cancellation.
6. A company shall not impose or collect a fee for the cancellation of a policy or agreement.
1. When an insurance policy is cancelled pursuant to NRS 686A.460, the insurer shall return the unearned premium to the company for credit to the account of the insured. The premium must be mailed to the company:
(a) Within 45 days after receipt of the notice of cancellation; or
(b) Immediately following an audit performed to determine the amount of the premium. If such an audit is performed, it must be completed within 60 days after receipt of the notice of cancellation.
2. If the returned portion of the premium exceeds the insured’s obligation to the company, the company shall pay the excess to the insured within 30 days after receipt, except that no refund is required if the excess is less than $1.
3. If the returned portion of the premium is less than the insured’s obligation to the company, the company shall notify the insured within 15 days making a demand for payment, except that the company shall not make a demand for payment if the obligation is less than $1.
4. The company shall notify the agent who submitted the agreement of any refund paid directly to the insured pursuant to subsection 2 at the time the refund is paid. Within 15 days after receipt of this notice, the agent shall refund to the insured any unearned commissions which are owed to the insured as a result of the cancellation.
5. The company shall notify the agent who submitted the agreement of any deficiency. Within 30 days after receipt of the notice, the agent shall refund to the insured any unearned commissions which are owed to the insured as a result of the cancellation.
1. Membership in a motor club, as that term is defined in NRS 696A.050; or
2. A policy of insurance covering accidental death or dismemberment, whether or not the policy is sold in combination with another policy.
(Added to NRS by 1985, 1157)
1. No agreement may contain a provision allowing a company recourse against the agent who submitted the agreement based upon the insured’s default in payments.
2. A company, broker or an agent of a company shall not offer to any person as an inducement to enter an agreement any gift, rebate or other consideration unless the consideration is an article of less than $2 in value which includes an advertisement of the company. This subsection does not prohibit a company from providing to a broker or an agent who submits the agreement to the company any supplies or equipment necessary to submit the agreement to the company. Any such supplies or equipment which is not disposable remains the property of the company.
3. A company or an agent or broker submitting an agreement shall not:
(a) Induce or attempt to induce an insured to become obligated under more than one agreement to obtain more than one initial charge for entering the agreement.
(b) Write any insurance in connection with the agreement, including life or health insurance limited to the amount advanced on behalf of the insured.
1. Any licensed resident or nonresident agent or broker who has any financial interest in a company, other than in submitting agreements through the company, shall disclose to the insured, in the manner prescribed by the Commissioner, his or her interest in the company.
2. A licensed resident or nonresident agent or broker who submits any agreement shall not accept any compensation for arranging, directing or performing services in connection with the agreement. A company shall not pay or offer to pay any compensation to a licensed resident or nonresident agent or broker who submits an agreement to the company.
1. A person who violates the provisions of NRS 686A.340 shall be punished by a fine of not more than $200 per day or $500 per agreement per day for every day the violation continues, whichever is greater.
2. For the purposes of subsection 1, unless the context requires that a section apply only to insurers, any reference in those sections to “insurer” must be replaced by a reference to “company.”
USE OF CONSUMER CREDIT INFORMATION
NRS 686A.600 Definitions. As used in NRS 686A.600 to 686A.730, inclusive, unless the context otherwise requires, the words and terms defined in NRS 686A.610 to 686A.660, inclusive, have the meanings ascribed to them in those sections.
NRS 686A.610 “Adverse action” defined. “Adverse action” means a denial or cancellation of, an increase in any charge for, or a reduction or other adverse or unfavorable change in the terms of coverage or amount of, any insurance, existing or applied for, in connection with any policy.
(Added to NRS by 2003, 2801)
(Added to NRS by 2003, 2802)
NRS 686A.630 “Consumer credit report” defined. “Consumer credit report” means any written, oral or other communication of information by a consumer reporting agency bearing on the credit worthiness, credit standing or credit capacity of an applicant or policyholder, and which is used or expected to be used or collected in whole or in part for the purpose of serving as a factor to determine:
1. Whether to issue, cancel or renew a policy; or
2. The amount of the premium for a policy.
(Added to NRS by 2003, 2802)
NRS 686A.640 “Consumer reporting agency” defined. “Consumer reporting agency” means any person which, for monetary fees, dues or on a cooperative nonprofit basis, regularly engages in whole or in part in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer credit reports to third parties.
(Added to NRS by 2003, 2802)
NRS 686A.650 “Credit information” defined. “Credit information” means any information that is related to credit and derived from a consumer credit report, found on a consumer credit report or provided on an application for a policy. The term does not include information that is not related to credit, regardless of whether it is contained in a consumer credit report or in an application for a policy, or is used to calculate an insurance score.
(Added to NRS by 2003, 2802)
NRS 686A.660 “Insurance score” defined. “Insurance score” means a number or rating that is derived from an algorithm, computer application, model or other process that is based in whole or in part on credit information for the purposes of predicting the future losses or exposure with regard to an applicant or policyholder.
(Added to NRS by 2003, 2802)
NRS 686A.670 Applicability. The provisions of NRS 686A.600 to 686A.730, inclusive, do not apply to a contract of surety insurance issued pursuant to chapter 691B of NRS or any commercial or business policy.
1. An insurer that uses information from a consumer credit report shall not:
(a) Use an insurance score that is calculated using income, gender, sexual orientation, gender identity or expression, address, zip code, ethnic group, religion, marital status or nationality of the consumer as a factor, or would otherwise lead to unfair or invidious discrimination.
(b) Deny, cancel or fail to renew a policy on the basis of credit information unless the insurer also considers other applicable underwriting factors that are independent of credit information and not expressly prohibited by this section.
(c) Base renewal rates for a policy upon credit information unless the insurer also considers other applicable factors independent of credit information.
(d) Take an adverse action against an applicant or policyholder based on the applicant or policyholder not having a credit card account unless the insurer also considers other applicable factors independent of credit information.
(e) Consider an absence of credit information or an inability to calculate an insurance score in underwriting or rating a policy unless the insurer does any one of the following:
(1) Treats the applicant or policyholder as otherwise approved by the Commissioner, after the insurer presents to the Commissioner information indicating that such an absence or inability relates to the risk for the insurer.
(2) Treats the applicant or policyholder as if the applicant or policyholder had neutral credit information, as defined by the insurer.
(3) Excludes the use of credit information as a factor, and uses only underwriting criteria other than credit information.
(f) Take an adverse action against an applicant or policyholder based on credit information, unless an insurer obtains and uses a consumer credit report issued or an insurance score calculated within 90 days from the date the policy is first written or renewal is issued.
(g) Use the following as a negative factor in any insurance scoring methodology or in reviewing credit information for the purpose of underwriting or rating a policy:
(1) Credit inquiries not initiated by the applicant or policyholder, or inquiries requested by the applicant or policyholder for his or her own credit information.
(2) Inquiries relating to insurance coverage, if so identified on the consumer credit report.
(3) Collection accounts relating to medical treatment, if so identified on the consumer credit report.
(4) Multiple lender inquiries, if identified on the consumer credit report as being related to home loans or mortgages and made within 30 days of one another, unless only one inquiry is considered.
(5) Multiple lender inquiries, if identified on the consumer credit report as being related to a loan for an automobile and made within 30 days of one another, unless only one inquiry is considered.
2. Except as otherwise provided in this subsection, at the time of the annual renewal of a policyholder’s policy, an insurer that uses information from a consumer credit report shall, upon the request of the policyholder or the policyholder’s agent, reunderwrite and rerate the policy based upon a current consumer credit report or insurance score. An insurer need not, at the request of a policyholder or the policyholder’s agent, recalculate the insurance score of or obtain an updated consumer credit report of the policyholder more frequently than once in any 12-month period.
1. Notwithstanding any other law or regulation, an insurer that uses credit information shall, upon receipt of a written request from an applicant or policyholder, provide reasonable exceptions to the insurer’s rates, rating classifications, company or tier placement, or underwriting rules or guidelines for an applicant or policyholder who has experienced and whose credit information has been directly influenced by any of the following:
(a) A catastrophic event, as declared by the Federal or State Government;
(b) A serious illness or injury, or a serious illness or injury to an immediate family member;
(c) The death of a spouse, child or parent;
(d) Divorce or involuntary interruption of legally-owed alimony or support payments;
(e) Identify theft;
(f) Temporary loss of employment for a period of 3 months or more, if it results from involuntary termination;
(g) Military deployment overseas; or
(h) Other events, as determined by the insurer.
2. If an applicant or policyholder submits a request for an exception as set forth in subsection 1, an insurer may, in its sole discretion:
(a) Require the applicant or policyholder to provide reasonable written and independently verifiable documentation of the event;
(b) Require the applicant or policyholder to demonstrate that the event had direct and meaningful impact on the credit information of the applicant or policyholder;
(c) Require that such a request be made not more than 60 days after the date of the application for insurance or the policy renewal;
(d) Grant an exception despite the applicant or policyholder not providing the initial request for an exception in writing; or
(e) Grant an exception where the applicant or policyholder asks for consideration of repeated events or the insurer has considered this event previously.
3. An insurer is not out of compliance with any law or rule relating to underwriting, rating or rate filing as a result of granting an exception under this section. Nothing in this section shall be construed to provide an applicant or policyholder with a cause of action that does not exist in the absence of this section.
4. The insurer shall provide notice to each applicant and policyholder that reasonable exceptions are available and include information about how the applicant or policyholder may inquire further about such exceptions.
5. Within 30 days after the insurer’s receipt of sufficient documentation of an event described in subsection 1, the insurer shall inform the applicant or policyholder of the outcome of the request for a reasonable exception. Such communication must be in writing or provided to the applicant or policyholder in the same medium as the request.
6. The Commissioner may adopt regulations to carry out the provisions of this section.
(Added to NRS by 2011, 3367)
NRS 686A.690 Reunderwriting or rerating of insured; refund of premium. If it is determined pursuant to the dispute resolution process set forth in section 611(a) of the federal Fair Credit Reporting Act, 15 U.S.C. § 1681i(a), that the credit information of a policyholder was incorrect or incomplete and if the insurer receives notice of such determination from either the consumer reporting agency or from the policyholder, the insurer shall reunderwrite and rerate the policyholder within 30 days of receiving the notice. After reunderwriting or rerating the insured, the insurer shall make any adjustments necessary, consistent with its underwriting and rating guidelines. If an insurer determines that the policyholder has overpaid a premium, the insurer shall refund to the policyholder the amount of overpayment calculated back to the shorter of either the last 12 months of coverage or the actual period of the policy.
(Added to NRS by 2003, 2804)
1. If an insurer uses credit information in underwriting or rating an applicant, the insurer or its agent shall disclose, either on the application for the policy or at the time the application is taken, that the insurer may obtain credit information in connection with the application. The disclosure must be written or provided to an applicant in the same medium as the application. The insurer need not provide the disclosure required pursuant to this subsection to a policyholder upon renewal of a policy if the policyholder was previously provided the disclosure in connection with the policy. An insurer may comply with the requirements of this subsection by providing the following statement:
In connection with this application for insurance, we may review your credit report or obtain or use a credit-based insurance score based on the information contained in that credit report. We may use a third party in connection with the development of your insurance score.
2. The Division shall post on its Internet website a list of each insurer that does not use an insurance score when underwriting, rating an applicant for or calculating the premium for a policy of insurance for a passenger car or homeowner’s insurance and shall update this list on July 1 of each year.
3. The Division may post on its Internet website, without limitation:
(a) General information concerning the use of an insurance score in underwriting, rating an applicant for or calculating the premium for a policy of insurance; and
(b) Applicable laws governing the manner in which an insurance score may be used.
4. As used in this section, “passenger car” has the meaning ascribed to it in NRS 482.087.
1. Provide notice to the applicant or policyholder that an adverse action has been taken, in accordance with the requirements of section 615(a) of the federal Fair Credit Reporting Act, 15 U.S.C. § 1681m(a).
2. Provide notice to the applicant or policyholder explaining the reasons for the adverse action. The reasons must be provided in sufficiently clear and specific language so that a person can identify the basis for the insurer’s decision to take the adverse action. The notice must include a description of not more than four factors that were the primary influences of the adverse action. The use of generalized terms such as “poor credit history,” “poor credit rating” or “poor insurance score” does not meet the requirements of this subsection. The notice required by this subsection must be provided in a form approved by the Commissioner.
1. An insurer shall indemnify, defend and hold harmless an agent of the insurer from and against all liability, fees and costs arising out of or relating to the actions, errors or omissions of the agent with regard to obtaining or using credit information or insurance scores for the insurer, if the agent follows the instructions of or procedures established by the insurer and complies with any applicable law or regulation.
2. This section does not provide, expand, limit or prohibit any cause of action an applicant or policyholder may have against an agent of an insurer.
(Added to NRS by 2003, 2804)
1. A consumer reporting agency shall not provide or sell data or lists that include any information that in whole or in part was submitted in conjunction with:
(a) An inquiry by or for an insurer about the credit information of an applicant or policyholder; or
(b) A request for a credit report or insurance score.
2. The information described in subsection 1 includes, without limitation:
(a) The expiration date of a policy or any other information that may identify time periods during which a policy of an applicant or policyholder may expire; and
(b) The terms and conditions of the coverage provided by a policy of an applicant or policyholder.
3. The restriction set forth in subsection 1 does not apply to data or lists the consumer reporting agency supplies to the insurer, or an agent or affiliate of the insurer, from whom the information was received.
4. The provisions of this section do not restrict any insurer from being able to obtain a report regarding a motor vehicle or a report of a history of claims.
(Added to NRS by 2003, 2805)