Nrs: Chapter 679A - General Provisions

Link to law: https://www.leg.state.nv.us/NRS/NRS-679A.html
Published: 2015

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[Rev. 2/11/2015 11:48:54

AM--2014R2]

TITLE 57 - INSURANCE

CHAPTER 679A - GENERAL PROVISIONS

NRS 679A.010        Short

title.

NRS 679A.020        Definitions.

NRS 679A.030        “Authorized”

and “unauthorized” insurer defined.

NRS 679A.040        “Bona

fide resident” defined.

NRS 679A.050        “Code”

defined.

NRS 679A.060        “Commissioner”

defined.

NRS 679A.085        “Division”

defined.

NRS 679A.090        “Domestic,”

“foreign” and “alien” insurer defined.

NRS 679A.092        “Federal

Act” defined.

NRS 679A.094        “Grandfathered

plan” defined.

NRS 679A.095        “Hospice

care” defined.

NRS 679A.097        “Individual”

defined.

NRS 679A.100        “Insurer”

defined.

NRS 679A.112        “Policy”

defined.

NRS 679A.115        “Premium”

defined.

NRS 679A.117        “Producer

of insurance” defined.

NRS 679A.118        “Provider

of insurance” defined.

NRS 679A.119        “Rating

characteristic” defined.

NRS 679A.120        “State”

defined.

NRS 679A.130        “Transacting

insurance” defined.

NRS 679A.140        Purposes;

construction.

NRS 679A.150        Compliance

required.

NRS 679A.160        Application

of Code to particular types of insurers.

NRS 679A.165        Required

manner of obtaining insurance.

NRS 679A.170        Particular

provisions prevail.

NRS 679A.180        General

penalty; penalty in addition to administrative discipline.

NRS 679A.190        Disciplinary

proceeding, fine and penalty authorized after expiration or voluntary surrender

of license or certificate issued pursuant to Code.

NRS 679A.200        Prohibiting

fee to include provider of health care on panel of providers; penalty; award of

costs and attorney’s fees.

_________

_________

 

      NRS 679A.010  Short title.  This

title shall be known and may be cited as the Nevada Insurance Code.

      (Added to NRS by 1971, 1557)

      NRS 679A.020  Definitions.  As

used in this Code, unless the context otherwise requires, the words and terms

defined in NRS 679A.030 to 679A.130,

inclusive, have the meanings ascribed to them in those sections.

      (Added to NRS by 1971, 1557; A 1983, 1933; 1991, 1613; 1993, 1897; 2001, 2179; 2013, 3597)

      NRS 679A.030  “Authorized” and “unauthorized” insurer defined.

      1.  An “authorized” insurer is one

authorized to transact insurance or reinsurance in this State under a

subsisting certificate of authority issued by the Commissioner.

      2.  An “unauthorized” insurer is one not so

authorized.

      (Added to NRS by 1971, 1557; A 1987, 641)

      NRS 679A.040  “Bona fide resident” defined.  “Bona

fide resident” means a person who actually resides in this state with

domiciliary intent.

      (Added to NRS by 1971, 1558)

      NRS 679A.050  “Code” defined.  “Code”

means the Nevada Insurance Code.

      (Added to NRS by 1971, 1558)

      NRS 679A.060  “Commissioner” defined.  “Commissioner”

means the Commissioner of Insurance.

      (Added to NRS by 1971, 1558)

      NRS 679A.085  “Division” defined.  “Division”

means the Division of Insurance of the Department of Business and Industry.

      (Added to NRS by 1993, 1897)

      NRS 679A.090  “Domestic,” “foreign” and “alien” insurer defined.

      1.  A “domestic” insurer is one:

      (a) Formed under the laws of Nevada, unless it

has converted into a foreign insurer; or

      (b) Which has converted into a domestic insurer.

      2.  A “foreign” insurer is one:

      (a) Formed under the laws of any jurisdiction

other than this state, unless it has converted into a domestic insurer; or

      (b) Which has converted into a foreign insurer.

      3.  An “alien” insurer is one formed under

the laws of any country other than the United States of America or any of its

states.

      4.  Except where distinguished by context,

“foreign” insurer includes also “alien” insurer.

      (Added to NRS by 1971, 1558; A 1983, 683)

      NRS 679A.092  “Federal Act” defined.  “Federal

Act” means the federal Patient Protection and Affordable Care Act, Public Law

111-148, as amended by the federal Health Care and Education Reconciliation Act

of 2010, Public Law 111-152, and any amendments to, or regulations or guidance

issued pursuant to, those acts.

      (Added to NRS by 2013, 3596)

      NRS 679A.094  “Grandfathered plan” defined.  “Grandfathered

plan” means a health benefit plan that meets the requirements of 42 U.S.C. §

18011.

      (Added to NRS by 2013, 3597)

      NRS 679A.095  “Hospice care” defined.  “Hospice

care” has the meaning ascribed to it in NRS

449.0115.

      (Added to NRS by 1983, 1933; A 1989, 1031)

      NRS 679A.097  “Individual” defined.  An

“individual” is a natural person.

      (Added to NRS by 1971, 1559; A 1985, 537)—(Substituted

in revision for NRS 679A.110)

      NRS 679A.100  “Insurer” defined.  “Insurer”

includes every person engaged as principal and as indemnitor, surety or

contractor in the business of entering into contracts of insurance.

      (Added to NRS by 1971, 1558)

      NRS 679A.112  “Policy” defined.  “Policy”

means the written contract of or written agreement for or effecting insurance,

by whatever name called, and includes all clauses, riders, endorsements and

papers which are a part thereof.

      (Added to NRS by 1981, 1141)

      NRS 679A.115  “Premium” defined.  “Premium”

means the consideration for insurance, by whatever name called. The term

includes any “assessment,” or any “membership,” “policy,” “survey,”

“inspection,” “service” or similar fee or other charge assessed or collected by

the insurer or an agent of the insurer in consideration for an insurance

contract or its procurement.

      (Added to NRS by 1981, 1141)

      NRS 679A.117  “Producer of insurance” defined.  “Producer

of insurance” means a person required to be licensed under the laws of this

state to sell, solicit or negotiate insurance.

      (Added to NRS by 2001, 2179)

      NRS 679A.118  “Provider of insurance” defined.  “Provider

of insurance” includes an insurer, producer of insurance, managing general

agent, third-party administrator, organization composed of or using preferred

providers of health care, health maintenance organization, commercial bank,

trust company, savings and loan association, credit union, thrift company,

financial holding company, affiliate or subsidiary of an insurer or financial

holding company, broker-dealer in securities, mortgage lender, and any other

person engaged in the business of insurance.

      (Added to NRS by 2001, 2179)

      NRS 679A.119  “Rating characteristic” defined.  “Rating

characteristic” means age, family composition, tobacco use or geographic rating

area.

      (Added to NRS by 2013, 3597)

      NRS 679A.120  “State” defined.  When

used in context signifying a jurisdiction other than the State of Nevada,

“state” means any state, district, commonwealth, territory or possession of the

United States of America.

      (Added to NRS by 1971, 1559; A 1983, 154)

      NRS 679A.130  “Transacting insurance” defined.  In

addition to other aspects of insurance operations to which provisions of this

Code by their terms apply, “transact” with respect to a business of insurance

includes any of the following, by mail or otherwise or whether or not for the

purpose of profit:

      1.  Solicitation or inducement.

      2.  Negotiations.

      3.  Effectuation of a contract of

insurance.

      4.  Transaction of matters subsequent to

effectuation and arising out of such a contract.

      (Added to NRS by 1971, 1559)

      NRS 679A.140  Purposes; construction.

      1.  The purposes of this Code are to:

      (a) Protect policyholders and all having an

interest under insurance policies;

      (b) Implement the public interest in the business

of insurance;

      (c) Provide adequate standards of solidity of

insurers, and of integrity and competence in conduct of their affairs in the

home offices and in the field;

      (d) Improve and thereby preserve state regulation

of insurance;

      (e) Insure that policyholders, claimants and

insurers are treated fairly and equitably;

      (f) Encourage full cooperation of the office of

Commissioner with other regulatory bodies, both of this and other states and of

the Federal Government;

      (g) Insure that the State has an adequate and

healthy insurance market characterized by competitive conditions and the

exercise of initiative;

      (h) Prevent misleading, unfair and monopolistic

practices in insurance operations; and

      (i) Continue to provide the State of Nevada with

a comprehensive, modern and adequate body of law, in response to the McCarran

Act (Public Law 15, 79th Congress, 15 U.S.C. §§ 1011 to 1015, inclusive), for

the effective regulation and supervision of insurance business transacted

within, or affecting interests of the people of this state.

      2.  The provisions of this Code shall be

given reasonable and liberal construction for the fulfillment of these

purposes.

      (Added to NRS by 1971, 1559)

      NRS 679A.150  Compliance required.  No

person shall transact a business of insurance in Nevada, or relative to a

subject of insurance resident, located or to be performed in Nevada or

elsewhere, without complying with the applicable provisions of this Code.

      (Added to NRS by 1971, 1560)

      NRS 679A.160  Application of Code to particular types of insurers.  Except as otherwise provided by specific

statute, no provision of this Code applies to:

      1.  Fraternal benefit societies, as

identified in chapter 695A of NRS, except

as stated in chapter 695A of NRS.

      2.  Hospital, medical or dental service

corporations, as identified in chapter 695B

of NRS, except as stated in chapter 695B of

NRS.

      3.  Motor clubs, as identified in chapter 696A of NRS, except as stated in chapter 696A of NRS.

      4.  Bail agents, as identified in chapter 697 of NRS, except as stated in NRS 680B.025 to 680B.039, inclusive, and chapter 697 of NRS.

      5.  Risk retention groups, as identified in

chapter 695E of NRS, except as stated in chapter 695E of NRS.

      6.  Captive insurers, as identified in chapter 694C of NRS, with respect to their

activities as captive insurers, except as stated in chapter 694C of NRS.

      7.  Health and welfare plans arising out of

collective bargaining under chapter 288 of

NRS, except that the Commissioner may review the plan to ensure that the

benefits are reasonable in relation to the premiums and that the fund is

financially sound.

      8.  Programs established pursuant to

subsection 1 of NRS 315.725 and the

entities administering those programs, except as stated in NRS 315.725.

      (Added to NRS by 1971, 1560; A 1971, 1931; 1983, 712; 1987, 1333; 1993, 2381; 1995, 467; 1997, 299, 3374; 1999, 3217; 2011, 581)

      NRS 679A.165  Required manner of obtaining insurance.  A

person who is required by statute to obtain insurance or any other type of

security as a condition of licensure or conducting business must obtain the

insurance or other security in the manner set forth in NRS 277.067, 277.069, 277.0695 or 315.725 or from an insurer who is licensed

or otherwise allowed to transact insurance under this title.

      (Added to NRS by 1993, 2380; A 2011, 581)

      NRS 679A.170  Particular provisions prevail.  Provisions

of this Code relative to a particular kind of insurance or type of insurer or

particular matter shall prevail over provisions relating to insurance in

general or insurers in general or to such matter in general.

      (Added to NRS by 1971, 1560)

      NRS 679A.180  General penalty; penalty in addition to administrative

discipline.

      1.  Unless the same is defined as a felony

under any other law of this state, or punishment provided therefor classifies

it otherwise, every violation of any provision of this Code is a misdemeanor.

      2.  Every penalty imposed by this Code

shall be in addition to any applicable suspension, revocation or denial of a

license or certificate of authority.

      (Added to NRS by 1971, 1560)

      NRS 679A.190  Disciplinary proceeding, fine and penalty authorized after

expiration or voluntary surrender of license or certificate issued pursuant to

Code.  The expiration or voluntary

surrender of a license or certificate issued pursuant to the provisions of this

Code does not:

      1.  Prohibit the Commissioner from

initiating or continuing a disciplinary proceeding against the holder of the

license or certificate; or

      2.  Prevent the imposition or collection of

any fine or penalty authorized pursuant to the provisions of this Code against

the holder of the license or certificate.

      (Added to NRS by 1999, 2783)

      NRS 679A.200  Prohibiting fee to include provider of health care on panel of

providers; penalty; award of costs and attorney’s fees.

      1.  If an organization establishes a panel

of providers of health care and makes the panel available for use by an insurer

when offering health care services pursuant to chapter

689A, 689B, 689C, 695A,

695B or 695C

of NRS, the organization shall not charge the insurer or a provider of health

care:

      (a) A fee to include the name of the provider on

the panel of providers of health care; or

      (b) Any other fee related to establishing a

provider of health care as a provider for the organization.

      2.  If an organization violates the

provisions of subsection 1, the organization shall pay to the insurer or

provider of health care, as appropriate, an amount that is equal to twice the

fee charged to the insurer or provider of health care.

      3.  A court shall award costs and

reasonable attorney’s fees to the prevailing party in an action brought

pursuant to this section.

      4.  In addition to any relief granted

pursuant to this section, if an organization violates the provisions of

subsection 1, and if an insurer offering health care services pursuant to chapter 689A, 689B,

689C, 695A,

695B or 695C

of NRS has a contract with or otherwise uses the services of the organization,

the Division shall require the insurer to suspend its performance under the

contract or discontinue using those services until the organization, as determined

by the Division:

      (a) Complies with the provisions of subsection 1;

and

      (b) Refunds to all providers of health care any

fees obtained by the organization in violation of subsection 1.

      (Added to NRS by 2003, 3349)