Idaho Code § 41-4406 — Idaho Code / Title 41 / Chapter 44 / Section 41-4406
41-4406 DISCLOSURE STANDARDS.
Status: in_force

41-4406. Disclosure standards. (1) In order to provide for full and fair disclosure in the sale of medicare supplement policies, no medicare supplement policy or certificate shall be delivered in this state unless an outline of coverage is delivered to the applicant at the time application is made.

(2) The director may prescribe the format and content of the outline of coverage required by this section. For purposes of this section, "format" means style, arrangements and overall appearance, including such items as the size, color and prominence of type and arrangement of text and captions. The outline of coverage shall include:

(a) A description of the principal benefits and coverage provided in the policy;

(b) A statement of the renewal provisions, including any reservation by the issuer of a right to change premiums;

(c) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.

(3) The director may prescribe by rule a standard form and the contents of an informational brochure for persons eligible for medicare, which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of medicare. Except in the case of direct response insurance policies, the director may require by rule that the informational brochure be provided to any prospective insureds eligible for medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the director may require by rule that the prescribed brochure be provided upon request to any prospective insureds eligible for medicare, but in no event later than the time of policy delivery.

(4) The director may adopt rules for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not medicare supplement coverages, for all accident and sickness insurance policies sold to persons eligible for medicare, other than:

(a) Medicare supplement policies; or

(b) Disability income policies.

(5) The director may adopt reasonable rules to govern the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, or certificates by persons eligible for medicare.

History:

[41-4406, added 1999, ch. 102, sec. 2, p. 325.]
Idaho Code § 41-1502 — Idaho Code / Title 41 / Chapter 15 / Section 41-1502
41-1502 DEFINITIONS.
Status: in_force

41-1502. Definitions. For the purposes of this chapter:

(1) "Actuary" means a person who is a member in good standing of the American academy of actuaries.

(2) "Insurer" means any person, firm, association or corporation duly licensed in this state as an insurance company pursuant to and acting consistent with the definitions provided in sections 41-103 and 41-112, Idaho Code.

(3) "Managing general agent" (MGA) means any person, firm, association or corporation who negotiates and binds ceding reinsurance contracts on behalf of an insurer or manages all or part of the insurance business of an insurer (including the management of a separate division, department or underwriting office) and acts as an agent for such insurer whether known as a managing general agent, manager or other similar term, who, with or without the authority, either separately or together with affiliates, produces, directly or indirectly, and underwrites an amount of gross direct written premium equal to or more than five per cent (5%) of the policyholder surplus as reported in the last annual statement of the insurer in any one (1) quarter or year together with one (1) or more of the following:

(a) Adjusts or pays claims in excess of an amount determined by the director, or

(b) Negotiates reinsurance on behalf of the insurer.

(4) Notwithstanding the above definition of MGA, the following persons shall not be considered as MGAs for the purposes of this chapter:

(a) An employee of the insurer;

(b) An United States manager of the United States branch of an alien insurer;

(c) An underwriting manager which, pursuant to contract, manages the insurance operations of the insurer, is under common control with the insurer, subject to the holding company regulatory act, and whose compensation is not based on the volume of premiums written;

(d) The attorney-in-fact authorized by and acting for the subscribers of a reciprocal insurer or interinsurance exchange under powers of attorney.

(5) "Underwrite" means the authority to accept or reject risks on behalf of the insurer.

History:

[41-1502, added 1991, ch. 293, sec. 1, p. 754.]
Idaho Code § 41-611A — Idaho Code / Title 41 / Chapter 6 / Section 41-611A
41-611A MORTGAGE GUARANTY INSURANCE — CONTINGENCY RESERVE.
Status: in_force

41-611A. Mortgage guaranty insurance — Contingency reserve. In addition to reserves for unearned premiums and losses, as to mortgage guaranty insurance transacted by it an insurer shall establish and maintain a contingency reserve out of net premiums (gross premiums less premiums returned to policy holders) remaining after establishment of the unearned premium reserve. To the contingency reserve the insurer shall contribute an amount equal to fifty per cent (50%) of such remaining premiums. The annual contributions to the contingency reserve made during each calendar year shall be maintained for a period of one hundred twenty (120) months; except that in any year in which incurred losses of the insurer under mortgage guaranty insurance policies exceed thirty-five per cent (35%) of the corresponding earned premiums, the insurer may withdraw from the contingency reserve an amount equal to not more than the amount of such excess.

History:

[I.C., sec. 41-611A, as added by 1972, ch. 79, sec. 2, p. 159.]
Idaho Code § 41-3408 — Idaho Code / Title 41 / Chapter 34 / Section 41-3408
41-3408 QUALIFICATIONS FOR CERTIFICATE OF AUTHORITY.
Status: in_force

41-3408. Qualifications for certificate of authority. The director shall not issue or permit to exist a certificate of authority to be or act as a service corporation, as to any corporation not fulfilling the following qualifications:

(1) Must be incorporated as provided in section 41-3406, Idaho Code, as a professional service corporation.

(2) Must intend to and actually conduct its business in good faith as a nonprofit corporation.

(3) Must have in force service agreements with participant licensees located in the areas of the subscribers' residences convenient as to location and sufficient in numbers, capacity and facilities reasonably to furnish respective categories of health care services then provided or proposed to be provided by the corporation to its subscribers. Said professional service corporation shall be ready and willing at all times to enter into service agreements with all licensees of the category or categories specified in its articles of incorporation who are qualified under the laws of the state of Idaho and who desire to become participant licensees of said corporation and who practice within the general area served by said professional service corporation.

(4) If a newly formed corporation, it must possess sufficient available working funds to pay all reasonably anticipated cost of acquisition of new business and operating expenses, other than payment for professional services, for a period of not less than the six (6) months next following the date of issuance of the certificate of authority, if issued.

(5) Nothing in this section shall preclude a service corporation from refusing to contract with a health care licensee who is unqualified or who does not meet the terms and conditions of the participating licensee contract of the service corporation or from terminating or refusing to renew the contract of a participating health care licensee who is unqualified or who does not comply with, or who refuses to comply with, the terms and conditions of the participating health care licensee contract including, but not limited to, practice standards and quality requirements. The contract shall provide for written notice to the participating health care licensee setting forth any breach of contract for which the service corporation proposes that the contract be terminated or not renewed and shall provide for a reasonable period of time for the participating health care licensee to cure such breach prior to termination or nonrenewal. If the breach has not been cured within such period of time the contract may be terminated or not renewed. Provided however, that if the breach of contract for which the service corporation proposes that the contract be terminated or not renewed is a willful breach, fraud or a breach which poses an immediate danger to the public health or safety, the contract may be terminated or not renewed immediately.

(6) Every service corporation issuing benefits pursuant to this chapter shall establish a grievance system for licensees. Such grievance system shall provide for arbitration according to chapter 9, title 7, Idaho Code, or for such other system which provides reasonable due process provisions for the resolution of grievances and the protection of the rights of the parties.

(7) Must fulfill all other applicable requirements of this chapter.

History:

[41-3408, added 1961, ch. 330, sec. 766, p. 645; am. 1965, ch. 46, sec. 2, p. 70; am. 1967, ch. 91, sec. 2, p. 194; am. 1967, ch. 399, sec. 4, p. 1194; am. 1969, ch. 36, sec. 4, p. 86; am. 1971, ch. 252, sec. 4, p. 1008; am. 1994, ch. 78, sec. 4, p. 179; am. 1994, ch. 275, sec. 2, p. 854; am. 2007, ch. 90, sec. 22, p. 259.]
Idaho Code § 41-1905 — Idaho Code / Title 41 / Chapter 19 / Section 41-1905
41-1905 INCONTESTABILITY.
Status: in_force

41-1905. Incontestability. There shall be a provision that the policy (exclusive of provisions relating to disability benefits or to additional benefits in the event of death by accident or accidental means) shall be incontestable, except for nonpayment of premiums, after it has been in force during the lifetime of the insured for a period of two (2) years from its date of issue.

History:

[41-1905, added 1961, ch. 330, sec. 436, p. 645.]
Idaho Code § 41-110 — Idaho Code / Title 41 / Chapter 1 / Section 41-110
41-110 “AUTHORIZED,” “UNAUTHORIZED” INSURER DEFINED.
Status: in_force

41-110. "Authorized," "unauthorized" insurer defined. (1) An "authorized" insurer is one duly authorized by a subsisting certificate of authority issued by the director to transact insurance in this state.

(2) An "unauthorized" insurer is one not so authorized.

History:

[41-110, added 1961, ch. 330, sec. 10, p. 645.]
Idaho Code § 41-3404 — Idaho Code / Title 41 / Chapter 34 / Section 41-3404
41-3404 PROVISIONS EXCLUSIVE.
Status: in_force

41-3404. Provisions exclusive. No provision of this code shall apply to any such health care service corporation unless contained or referred to in this chapter.

History:

[41-3404, added 1961, ch. 330, sec. 762, p. 645.]
Idaho Code § 41-5106 — Idaho Code / Title 41 / Chapter 51 / Section 41-5106
41-5106 DUTIES OF INSURERS UTILIZING THE SERVICES OF A REINSURANCE INTERMEDIARY — BROKER.
Status: in_force

41-5106. Duties of insurers utilizing the services of a reinsurance intermediary — Broker. (1) An insurer shall not engage the services of any person, firm, association or corporation to act as a RB on its behalf unless such person is licensed as required in section 41-5103(1), Idaho Code.

(2) An insurer may not employ an individual who is employed by a RB with which it transacts business, unless such RB is under common control with the insurer and subject to the provisions of chapter 38, title 41, Idaho Code.

(3) The insurer shall annually obtain a copy of the statement of the financial condition of each RB with which it transacts business.

History:

[41-5106, added 1992, ch. 82, sec. 1, p. 252.]
Idaho Code § 41-3409 — Idaho Code / Title 41 / Chapter 34 / Section 41-3409
41-3409 APPLICATION FOR CERTIFICATE OF AUTHORITY.
Status: in_force

41-3409. Application for certificate of authority. (1) Application for a certificate of authority to transact business as a service corporation shall be made to the director, on forms as prepared and furnished by the director and requiring such information relative to the applicant, its directors, officers, and affairs as the director may reasonably require consistent with this chapter.

(2) The application shall be accompanied by such of the following documents as may not already be on file with the director:

(a) One (1) copy of the applicant's articles of incorporation and of all amendments thereto, certified by the secretary of state;

(b) One (1) copy of the applicant's bylaws, certified by its corporate secretary;

(c) One (1) copy of each form of service agreement entered into or proposed to be entered into with participant licensees, together with a list showing the name, residence and office addresses, and date of execution of the service agreement by each such licensee;

(d) A copy of each form of subscriber's contract proposed to be offered;

(e) A schedule of the rates proposed to be charged subscribers;

(f) A financial statement of the applicant as of a date not more than thirty (30) days before the filing of the application, showing among other things the amount of working funds available to the applicant, the source of such funds, and accompanied by a copy of the agreement under which any such funds were contributed to or provided for the applicant; and

(g) A copy of any other relevant document reasonably requested by the director.

(3) At time of filing the application the applicant shall pay to the director the application fee and the fee for issuance of the certificate of authority as specified in section 41-3433, Idaho Code, (fee schedule).

History:

[41-3409, added 1961, ch. 330, sec. 767, p. 645; am. 1967, ch. 399, sec. 5, p. 1194; am. 1971, ch. 252, sec. 5, p. 1008; am. 1994, ch. 78, sec. 5, p. 180.]
Idaho Code § 41-2928 — Idaho Code / Title 41 / Chapter 29 / Section 41-2928
41-2928 SUBSCRIBERS' SHARE IN ASSETS.
Status: in_force

41-2928. Subscribers' share in assets. Upon the liquidation of a domestic reciprocal insurer, its assets remaining after discharge of its indebtedness and policy obligations, the return of any contributions of the attorney or other persons to its surplus made as provided in section 41-2916 of this chapter, and the return of any unused premium, savings, or credits then standing on subscribers' accounts, shall be distributed to its subscribers who were such within the twelve (12) months prior to the last termination of its certificate of authority, according to such reasonable formula as the director may approve.

History:

[41-2928, added 1961, ch. 330, sec. 655, p. 645.]
Idaho Code § 41-3819 — Idaho Code / Title 41 / Chapter 38 / Section 41-3819
41-3819 SANCTIONS.
Status: in_force

41-3819. Sanctions. (1) Any insurer failing, without just cause, to file any registration statement as required in this chapter shall be required, after notice and the opportunity for a hearing, to pay a penalty of two hundred dollars ($200) for each day of delay, to be recovered by the director, and the penalty so received shall be distributed to the general fund of the state of Idaho. The maximum penalty under this section is ten thousand dollars ($10,000). The director may reduce the penalty if the insurer demonstrates to the director that the imposition of the penalty would constitute a financial hardship to the insurer.

(2) Every director or officer of an insurance holding company system who knowingly violates, participates in or assents to, or who knowingly permits any of the officers or agents of the insurer to engage in transactions or make investments that have not been properly reported or submitted pursuant to section 41-3809(1), 41-3810(2) or 41-3812, Idaho Code, or who violates the provisions of this chapter shall pay, in their individual capacity, an administrative penalty of not more than five thousand dollars ($5,000) per violation, after notice and the opportunity for a hearing before the director. In determining the amount of the administrative penalty, the director shall take into account the appropriateness of the penalty with respect to the gravity of the violation, the history of any previous violations and such other matters as the interests of justice may require.

(3) Whenever it appears to the director that any insurer subject to this chapter or any director, officer, employee or agent thereof has engaged in any transaction or entered into a contract that is subject to section 41-3810 or 41-3812, Idaho Code, and that would not have been approved had approval been requested, the director may order the insurer to cease and desist immediately from any further activity under that transaction or contract. After notice and the opportunity for a hearing, the director may also order the insurer to void any contracts and restore the status quo if such action is in the best interest of the policyholders, creditors or the public.

(4) Whenever it appears to the director that any insurer or any director, officer, employee or agent thereof has committed a willful violation of this chapter, the director may seek criminal proceedings to be instituted by referring the matter to the attorney general or the county prosecutor in the county in which the principal office of the insurer is located, or if the insurer has no office in this state, then in Ada county, Idaho, against the insurer or the responsible director, officer, employee or agent thereof. Any insurer who willfully violates the provisions of this chapter may be fined not more than five thousand dollars ($5,000). Any individual who willfully violates the provisions of this chapter shall be guilty of a felony and may be imprisoned for not more than two (2) years or fined in his individual capacity not more than five thousand dollars ($5,000), or both.

(5) Any officer, director or employee of an insurance holding company system who willfully and knowingly subscribes to or makes or causes to be made any false statements or false reports or false filings with the intent to deceive the director in the performance of his duties under the provisions of this chapter, upon conviction shall be imprisoned for not more than three (3) years or fined five thousand dollars ($5,000), or both. Any fines imposed shall be paid by the officer, director or employee in his individual capacity.

(6) Whenever it appears to the director that any person has committed a violation of the provisions of section 41-3804, Idaho Code, and which prevents the director from fully understanding the enterprise risk to the insurer by affiliates or by the insurance holding company system, such violation may serve as an independent basis for the director's disapproval of dividends or distributions and for placing the insurer under an order of supervision in accordance with chapter 33, title 41, Idaho Code.

History:

[41-3819, added 2013, ch. 266, sec. 2, p. 673.]
Idaho Code § 41-4009 — Idaho Code / Title 41 / Chapter 40 / Section 41-4009
41-4009 INVESTMENT OF TRUST FUND.
Status: in_force

41-4009. Investment of trust fund. (1) The trustee may invest trust funds available for that purpose in the following kinds of investments only:

(a) General obligations of the United States government, or of any state, district, commonwealth, or territory of the United States, or of any municipality, county, or other political subdivision or agency thereof.

(b) Obligations, including the payment of principal and interest thereon of which are guaranteed by any such government or agency.

(c) Corporate bonds and similar obligations meeting the requirements specified for investment of funds of insurers under section 41-711, Idaho Code.

(d) Collateral loans, including payment of principal and interest of which are adequately secured by securities in which the trust fund could lawfully invest directly.

(e) Deposits, savings accounts, and share accounts in chartered banks and savings and loan associations located in the United States. An investment in any one (1) such institution may not be in excess of the amount covered by applicable deposit, savings, and share account insurance, unless otherwise authorized by the director.

(f) Investments as permitted by sections 41-714 and 41-716, Idaho Code, provided that the combined amount of such investments shall not exceed ten percent (10%) of the total assets of the trust fund.

(2) In addition to investments excluded under subsection (1) of this section, the trustee is expressly prohibited from investing trust fund moneys in:

(a) Any loan to or security of any plan sponsor including any employer or postsecondary educational institution participating in the plan, or to or of any trustee, officer, director, subsidiary or affiliate of any such plan sponsor, employer or postsecondary educational institution.

(b) The security of any person in which the trustee, administrator, or any consultant of the plan has a direct or indirect material pecuniary interest.

(c) Real property or loans thereon.

(d) Any personal loan.

(3) All such investments shall be made and held in the name of the trust fund, and the interest and yield thereon shall inure to the benefit of the trust fund.

(4) No investment shall be made by or on behalf of the trust fund unless authorized in writing by the trustee and included in the records of the trust fund.

(5) Any person who authorizes any investment of trust fund moneys in violation of this section shall, in addition to other penalties that may be applicable therefor, be liable for all loss suffered by the trust fund on account of the investment.

(6) No investment made in violation of this section shall constitute an "asset" in any determination of the financial condition of the trust fund.

History:

[41-4009, added 1974, ch. 248, sec. 9, p. 1624; am. 2006, ch. 414, sec. 8, p. 1263; am. 2013, ch. 181, sec. 9, p. 426.]
Idaho Code § 41-2910 — Idaho Code / Title 41 / Chapter 29 / Section 41-2910
41-2910 POWER OF ATTORNEY OR JOINT POWERS ENTITY.
Status: in_force

41-2910. Power of attorney or joint powers entity. (1) The rights and powers of the attorney or designated joint powers entity of a reciprocal insurer shall be as provided in the power of attorney given it by the subscribers.

(2) The power of attorney must set forth:

(a) The powers of the attorney;

(b) That the attorney is empowered to accept service of process on behalf of the insurer and to authorize the director to receive service of process in actions against the insurer upon contracts exchanged;

(c) The general services to be performed by the attorney or joint powers entity;

(d) The maximum amount to be deducted from advance premiums or deposits to be paid to the attorney and the general items of expense in addition to losses, to be paid by the insurer; and

(e) Except as to nonassessable policies, a provision for a contingent several liability of each subscriber in a specified amount which amount shall be not less than one (1) nor more than ten (10) times the premium or premium deposit stated in the policy.

(3) The power of attorney or joint exercise of powers agreement may:

(a) Provide for the right of substitution of the attorney and revocation of the power of attorney and rights thereunder;

(b) Impose such restrictions upon the exercise of the power as are agreed upon by the subscribers;

(c) Provide for the exercise of any right reserved to the subscribers directly or through their advisory committee; and

(d) Contain other lawful provisions deemed advisable.

(4) The terms of any power of attorney or agreement collateral thereto shall be reasonable and equitable, and no such power or agreement shall be used or be effective in this state until approved by the director.

History:

[41-2910, added 1961, ch. 330, sec. 637, p. 645; am. 1996, ch. 245, sec. 5, p. 778.]
Idaho Code § 41-2824 — Idaho Code / Title 41 / Chapter 28 / Section 41-2824
41-2824 FORMATION OF MUTUALS — FAILURE TO QUALIFY.
Status: in_force

41-2824. Formation of mutuals — Failure to qualify. If the proposed domestic mutual insurer fails to complete its organization and to secure its original certificate of authority within one (1) year from and after date of its certificate of incorporation, the corporation shall transact no further business, and the director shall return or cause to be returned to the persons entitled thereto all advance deposits or payments of premiums held in trust under section 41-2823.

History:

[41-2824, added 1961, ch. 330, sec. 592, p. 645.]
Idaho Code § 41-3619 — Idaho Code / Title 41 / Chapter 36 / Section 41-3619
41-3619 PROTECTION OF ACT NOT USED TO SELL INSURANCE.
Status: in_force

41-3619. Protection of act not used to sell insurance. It is an unfair trade practice for any insurer or agent to in any manner make use of the protection given policyholders by this chapter as a reason for buying insurance from him.

History:

[41-3619, added 1970, ch. 152, sec. 19, p. 462.]
Idaho Code § 41-348 — Idaho Code / Title 41 / Chapter 3 / Section 41-348
41-348 PROHIBITED ACTS — SERVICE PROVIDERS.
Status: in_force

41-348. Prohibited acts — Service providers. (1) It is unlawful for a person:

(a) Knowing that the payment is for the referral of a claimant to a service provider, either to accept payment from a service provider or, being a service provider, to pay another; or

(b) To provide or claim or represent to have provided services to a claimant, knowing the claimant was referred in violation of paragraph (a) of this subsection.

(2) It is unlawful for a service provider to engage in a regular practice of waiving, rebating, giving, paying, or offering to waive, rebate, give or pay all or part of a claimant's deductible or claim for casualty, disability insurance, worker's compensation insurance, health insurance or property insurance.

(3) As used in this section:

(a) "Health care services" means a service provided to a claimant for treatment of physical or mental illness or injury arising in whole or substantial part from trauma.

(b) "Service provider" means a person who directly or indirectly provides, advertises, or otherwise claims to provide services.

(c) "Services" means health care services, motor vehicle body or other motor vehicle repair and preparing, processing, presenting or negotiating an insurance claim against an insurance company.

(4) Any person or service provider violating the provisions of this section shall be subject to the monetary civil penalties provided in section 41-327, Idaho Code, as if the person or service provider were an insurer.

History:

[41-348, added 1996, ch. 402, sec. 1, p. 1335.]
Idaho Code § 41-4301 — Idaho Code / Title 41 / Chapter 43 / Section 41-4301
41-4301 SHORT TITLE.
Status: in_force

41-4301. short title. This chapter shall be known and may be cited as the "Idaho Life and Health Insurance Guaranty Association Act."

History:

[41-4301, added 2011, ch. 196, sec. 2, p. 559.]
Idaho Code § 41-4024 — Idaho Code / Title 41 / Chapter 40 / Section 41-4024
41-4024 SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.
Status: in_force

41-4024. Services provided by governmental entities. (1) From and after July 1, 1990, no self-funded plan shall be issued in Idaho which excludes from coverage services rendered the subscriber while a resident in an Idaho state institution, provided the services to the subscriber would be covered by the contract if rendered to him outside an Idaho state institution.

(2) From and after July 1, 1990, no self-funded plan may contain any provision denying or reducing benefits otherwise provided under the policy for the reason that the person insured is receiving health or mental health care or developmental services provided by the department of health and welfare, whether or not the department of health and welfare bases its charges for such services on the recipient's ability to pay. Provided, nothing in this section shall prevent the issuance of a contract which excludes or reduces benefits where the charge level or amount of the charge levied by a governmental entity for such services would vary or be affected in any way by the existence of coverage under a self-funded plan.

History:

[41-4024, added 1990, ch. 300, sec. 5, p. 830.]
Idaho Code § 41-3345 — Idaho Code / Title 41 / Chapter 33 / Section 41-3345
41-3345 UNCLAIMED AND WITHHELD FUNDS.
Status: in_force

41-3345. Unclaimed and withheld funds. (1) All unclaimed funds subject to distribution remaining in the liquidator's hands when he is ready to apply to the court for discharge, including the amount distributable to any creditor, shareholder, member, or other person who is unknown or cannot be found, shall be deposited with the state treasurer, and shall be paid without interest except in accordance with section 41-3342, Idaho Code, to the person entitled thereto or his legal representative upon proof satisfactory to the state treasurer of his right thereto. Any amount on deposit not claimed within six (6) years from discharge of the liquidator shall be deemed to have been abandoned and shall be escheated without formal escheat proceedings and be deposited with the state treasurer pursuant to chapter 5, title 14, Idaho Code.

(2) All funds withheld under section 41-3337, Idaho Code, and not distributed shall upon discharge of the liquidator be deposited with the state treasurer and paid by him in accordance with section 41-3342, Idaho Code. Any sums remaining which under section 41-3342, Idaho Code, would revert to the undistributed assets of the insurer shall be transferred to the state treasurer and become the property of the state under subsection (1) hereof, unless the director in his discretion petitions the court to reopen the liquidation under section 41-3347, Idaho Code.

History:

[41-3345, added 1981, ch. 249, sec. 2, p. 534; am. 2011, ch. 151, sec. 23, p. 430.]
Idaho Code § 41-614 — Idaho Code / Title 41 / Chapter 6 / Section 41-614
41-614 VALUATION OF OTHER SECURITIES.
Status: in_force

41-614. Valuation of other securities. (1) Securities, other than those referred to in section 41-613, Idaho Code, held by an insurer may be valued, in the discretion of the director:

(a) At their market value if market value can be reasonably ascertained, or

(b) If the issuer is an insurer, at their unadjusted book value as determined by the issuer's convention form financial statement filed with insurance public supervisory officials, or

(c) Any other value which the insurer can substantiate to the satisfaction of the director. In addition to other applicable bases of valuation, the director shall give due consideration to valuation based upon:

(i) The net worth of the issuer as shown by financial statements acceptable to the director.

(ii) The acquisition cost of the security to the insurer, adjusted in accordance with generally accepted accounting principles to reflect changes since such acquisition in the issuer's financial condition and business.

(2) Preferred or guaranteed stocks or shares while paying full dividends may be carried at a fixed value in lieu of market value, according to a generally accepted method of computation approved by the director.

(3) Stock of a subsidiary corporation of an insurer shall not be valued at an amount in excess of the net value thereof as based upon those assets only of the subsidiary which would be eligible under chapter 7, title 41, Idaho Code, for investment of the funds of the insurer directly.

(4) No valuations under this section shall be inconsistent with any applicable valuation or method then currently formulated or approved by the national association of insurance commissioners or its successor organization.

History:

[41-614, added 1961, ch. 330, sec. 135, p. 645; am. 1971, ch. 122, sec. 3, p. 408; am. 1972, ch. 369, sec. 7, p. 1072; am. 1993, ch. 194, sec. 6, p. 499.]
Idaho Code § 41-2714 — Idaho Code / Title 41 / Chapter 27 / Section 41-2714
41-2714 CLOSING OR SETTLEMENT PROTECTION.
Status: in_force

41-2714. closing or settlement protection. (1) A title insurer may issue closing or settlement protection to a buyer, borrower or lender that is a party to a transaction in which a title insurance policy will be issued. The closing or settlement protection shall be on a form filed with the department in accordance with section 41-2705, Idaho Code.

(2) The closing or settlement protection shall be limited to indemnifying the buyer, borrower or lender insured against a loss due to either or both of the following actions of a licensed and authorized title insurance agent and is deemed for the purpose of this section to be within the business of title insurance as set forth in section 41-2704, Idaho Code:

(a) Theft or misappropriation of closing or settlement funds in connection with a transaction in which a title insurance policy or title insurance policies will be issued by or on behalf of the title insurer issuing the closing or settlement protection.

(b) Failure to comply with the written closing instructions when agreed to by the title agent or title insurer, but only to the extent that the failure to follow the instructions relates to the status of the title to that interest in land or the validity, enforceability and priority of the lien of the mortgage on that interest in land.

(3) A rate must be charged and the rate charged by a title insurer for each transaction that includes closing protection coverage shall not be subject to any agreement requiring a division of rates or premiums collected on behalf of the title insurer. The issuance of a closing or settlement protection to a buyer, borrower or lender that is a party to a transaction in which a title insurance policy will be issued shall be considered to be one (1) transaction for which a single rate is charged and shall not result in a separate charge to each party. The rate shall:

(a) Be filed with the department in accordance with sections 41-2706 and 41-2707, Idaho Code;

(b) Be the only rate charged for closing protection; and

(c) Not exceed twenty-five dollars ($25.00).

(4) A title insurer may not provide any other protection that purports to indemnify against improper acts or omissions of a person with regard to closing or settlement services.

(5) Except as otherwise provided for in closing or settlement protection, a buyer, borrower, lender, or title insurer retains all their respective rights and remedies in connection with losses suffered due to theft or misappropriation of closing or settlement funds or the failure to comply with written closing instructions. Nothing in this section shall be construed to require a buyer, borrower or lender to obtain closing or settlement protection. A failure to obtain closing or settlement protection shall not be construed as an error, omission or other breach of duty of a buyer, borrower or lender.

History:

[41-2714, added 2015, ch. 275, sec. 3, p. 1133.]
Idaho Code § 41-3340 — Idaho Code / Title 41 / Chapter 33 / Section 41-3340
41-3340 CLAIMS OF SURETY.
Status: in_force

41-3340. Claims of surety. Whenever a creditor whose claim against an insurer is secured, in whole or in part, by the undertaking of another person, fails to prove and file that claim, the other person may do so in the creditor's name, and shall be subrogated to the rights of the creditor, whether the claim has been filed by the creditor or by the other person in the creditor's name, to the extent that he discharges the undertaking. In the absence of an agreement with the creditor to the contrary, the other person shall not be entitled to any distribution, however, until the amount paid to the creditor on the undertaking plus the distributions paid on the claim from the insurer's estate to the creditor equals the amount of the entire claim of the creditor. Any excess received by the creditor shall be held by him in trust for such other person. The term "other person" as used in this section is not intended to apply to a guaranty association or foreign guaranty association.

History:

[41-3340, added 1981, ch. 249, sec. 2, p. 532.]
Idaho Code § 41-2107 — Idaho Code / Title 41 / Chapter 21 / Section 41-2107
41-2107 GRACE PERIOD.
Status: in_force

41-2107. Grace period. There shall be a provision as follows:

"Grace Period: A grace period of….(insert a number not less than '7' for weekly premium policies, '10' for monthly premium policies and '31' for all other policies) days will be granted for the payment of each premium falling due after the first premium, during which grace period the policy shall continue in force."

A policy in which the insurer reserves the right to refuse renewal shall have, at the beginning of the above provision:

"Unless not less than thirty (30) days prior to the premium due date the insurer has delivered to the insured or has mailed to his last address as shown by the records of the insurer written notice of its intention not to renew this policy beyond the period for which the premium has been accepted."

History:

[41-2107, added 1961, ch. 330, sec. 496, p. 645.]
Idaho Code § 41-5111 — Idaho Code / Title 41 / Chapter 51 / Section 41-5111
41-5111 PENALTIES AND LIABILITIES.
Status: in_force

41-5111. Penalties and liabilities. (1) A reinsurance intermediary, insurer or reinsurer found by the director, after a hearing conducted in accordance with chapter 52, title 67, Idaho Code, to be in violation of any provision(s) of this chapter shall:

(a) For each separate violation, pay a penalty in an amount not exceeding five thousand dollars ($5,000);

(b) Be subject to revocation or suspension of its license; and

(c) If a violation was committed by the reinsurance intermediary, such reinsurance intermediary shall make restitution to the insurer, reinsurer, rehabilitator or liquidator of the insurer or reinsurer for the net losses incurred by the insurer or reinsurer attributable to such violation.

(2) The decision, determination or order of the director pursuant to subsection (1) of this section shall be subject to judicial review pursuant to chapter 52, title 67, Idaho Code.

(3) Nothing contained in this section shall affect the right of the director to impose any other penalties provided in the insurance law.

(4) Nothing contained in this chapter is intended to or shall in any manner limit or restrict the rights of policyholders, claimants, creditors or other third parties or confer any rights to such persons.

History:

[41-5111, added 1992, ch. 82, sec. 1, p. 256.]
Idaho Code § 41-3204 — Idaho Code / Title 41 / Chapter 32 / Section 41-3204
41-3204 TERMS USED.
Status: in_force

41-3204. Terms used. Whenever used in this chapter:

(1) "Benefit contract" shall mean the agreement for provision of benefits authorized by section 41-3216, Idaho Code, as that agreement is described in section 41-3219(1), Idaho Code.

(2) "Benefit member" shall mean an adult member who is designated by the laws or rules of the society to be a benefit member under a benefit contract.

(3) "Certificate" shall mean the document issued as written evidence of the benefit contract.

(4) "Director" shall mean the director of the department of insurance of this state.

(5) "Laws" shall mean the society's articles of incorporation, constitution and bylaws, however designated.

(6) "Lodge" shall mean subordinate member units of the society, known as camps, courts, councils, branches or by any other designation.

(7) "Premiums" shall mean premiums, rates, dues or other required contributions by whatever name known, which are payable under the certificate.

(8) "Rules" shall mean all rules, regulations or resolutions adopted by the supreme governing body or board of directors which are intended to have general application to the members of the society.

(9) "Society" shall mean fraternal benefit society, unless otherwise indicated.

History:

[41-3204, added 1995, ch. 213, sec. 2, p. 724.]
Idaho Code § 41-307 — Idaho Code / Title 41 / Chapter 3 / Section 41-307
41-307 AUTHORIZATION FOR INVESTMENT PURPOSES ONLY.
Status: in_force

41-307. Authorization for investment purposes only. A foreign insurer may make investments in this state without certificate of authority as provided by section 30-21-502, Idaho Code. Such an insurer shall not be subject to any other provision of this code.

History:

[41-307, added 1961, ch. 330, sec. 70, p. 645; am. 1980, ch. 197, sec. 27, p. 453; am. 1999, ch. 65, sec. 2, p. 169; am. 2017, ch. 58, sec. 20, p. 116.]
Idaho Code § 41-344 — Idaho Code / Title 41 / Chapter 3 / Section 41-344
41-344 EFFECTIVE DATE OF REDOMESTICATION.
Status: in_force

41-344. Effective date of redomestication. A redomestication under section 41-342, Idaho Code, shall become effective upon the issuance of a certificate of redomestication by the secretary of state, or such later date as may be set forth in the notice from the director; provided, however, that an insurer which has redomesticated in the state of Idaho pursuant to section 41-342, Idaho Code, shall be considered to be the same corporation as that corporation which existed under the laws of the state in which it was formerly domiciled and shall be considered as having been an operating insurer from the date that the corporation was authorized to do business as an insurer in its original state of incorporation.

History:

[41-344, added 1987, ch. 302, sec. 3, p. 642.]
Idaho Code § 41-2131 — Idaho Code / Title 41 / Chapter 21 / Section 41-2131
41-2131 REQUIREMENTS OF OTHER JURISDICTIONS.
Status: in_force

41-2131. Requirements of other jurisdictions. (1) Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized.

(2) Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.

History:

[41-2131, added 1961, ch. 330, sec. 520, p. 645.]
Idaho Code § 41-3353 — Idaho Code / Title 41 / Chapter 33 / Section 41-3353
41-3353 ANCILLARY FORMAL PROCEEDINGS.
Status: in_force

41-3353. Ancillary formal proceedings. (1) If a domiciliary liquidator has been appointed for an insurer not domiciled in this state, the director may file a petition with the district court requesting appointment as ancillary receiver in this state:

(a) If he finds that there are sufficient assets of the insurer located in this state to justify the appointment of an ancillary receiver; and

(b) If the protection of creditors or policyholders in this state so requires.

(2) The court may issue an order appointing an ancillary receiver in whatever terms it shall deem appropriate. The filing or recording of the order with the recorder of deeds in this state imparts the same notice as a deed, bill of sale, or other evidence of title duly filed or recorded with that recorder of deeds.

(3) When a domiciliary liquidator has been appointed in a reciprocal state, then the ancillary receiver appointed in this state may, whenever necessary, aid and assist the domiciliary liquidator in recovering assets of the insurer located in this state. The ancillary receiver shall, as soon as practicable, liquidate from their respective securities those special deposit claims and secured claims which are proved and allowed in the ancillary proceedings in this state, and shall pay the necessary expenses of the proceedings. He shall promptly transfer all remaining assets, books, accounts and records to the domiciliary liquidator. Subject to this section, the ancillary receiver and his deputies shall have the same powers and be subject to the same duties with respect to the administration of assets as a liquidator of an insurer domiciled in this state.

(4) When a domiciliary liquidator has been appointed in this state, ancillary receivers appointed in reciprocal states shall have, as to assets and books, accounts, and other records in their respective states, corresponding rights, duties and powers to those provided in subsection (3) of this section for ancillary receivers appointed in this state.

History:

[41-3353, added 1981, ch. 249, sec. 2, p. 537.]
Idaho Code § 41-1430 — Idaho Code / Title 41 / Chapter 14 / Section 41-1430
41-1430 DISCLOSURE OF INFORMATION AND IMMUNITY.
Status: in_force

41-1430. Disclosure of information and immunity. (1) Information acquired as a result of any inspection or survey by any rating organization or advisory organization shall be disclosed, upon request, to any requesting person with an insurable interest in the property and to any person designated by regulation of the Idaho department of insurance. The rating organization or advisory organization may require the person requesting the information to pay the reasonable costs of duplicating the information requested.

(2) No rating organization, advisory organization, or its officers, directors, employees, or any of its members, shall be civilly liable for the information contained in any of its records or reports prepared in good faith and in accordance with this chapter. No rating organization, advisory organization, or its officers, directors or employees or any of its members shall have a duty to disclose the information contained in their records or reports except as provided in this chapter.

History:

[41-1430, added 1982, ch. 347, sec. 1, p. 862.]
Idaho Code § 41-1227 — Idaho Code / Title 41 / Chapter 12 / Section 41-1227
41-1227 RECORDS OF BROKER.
Status: in_force

41-1227. Records of broker. (1) Each broker shall keep in his office a full and true record of each surplus line coverage procured by him, including a copy of each daily report, if any, a copy of each certificate of insurance issued by him, and such of the following items as may be applicable:

(a) Amount of the insurance;

(b) Gross premium charged;

(c) Return premium paid, if any;

(d) Rate of premium charged upon the several items of property;

(e) Effective date of the contract, and the terms thereof;

(f) Name and address of each insurer on the direct risk and the proportion of the entire risk assumed by such insurer if less than the entire risk;

(g) Name and address of the insured;

(h) Brief general description of the property of risk injured and where located or to be performed; and

(i) Other information as may be required by the director.

(2) The record shall at all times within five (5) years after issuance of the coverage to which it relates be open to examination in this state by the director.

History:

[41-1227, added 1961, ch. 330, sec. 271, p. 645; am. 2002, ch. 91, sec. 10, p. 231.]
Idaho Code § 41-3104 — Idaho Code / Title 41 / Chapter 31 / Section 41-3104
41-3104 INSURING POWERS.
Status: in_force

41-3104. Insuring powers. Within the limits of restrictions set forth in its articles of incorporation and otherwise under this chapter, such an insurer may:

(1) Issue property insurance, as defined in section 41-504, Idaho Code, as to farm property and personal property reasonably associated therewith, churches and public halls, and certain other dwellings and property as specified below, all as follows:

(a) The property insured must be owned by a member of the insurer, and must (except as expressly provided in this section) be located within the county or counties in which the insurer is authorized to transact insurance as provided in section 41-3105, Idaho Code;

(b) The insurer shall not insure any property located within the limits of any incorporated city, town, or village, except as follows:

(i) The insurer may insure dwellings and/or household goods owned by its members who, after becoming such members, have moved within the limits of any such incorporated city, town, or village;

(ii) The insurer may insure property of a member located upon an otherwise open tract of land occupied by the member and not less than five (5) acres in area, within the limits of any such city, town, or village; and

(iii) The insurer may insure grange halls, wherever located in this state.

(2) The insurer may insure other buildings and/or contents owned by its members individually or as an organization and not located within any city, town, or village with population in excess of one hundred twenty-five (125).

(3) The insurer may insure churches and other public halls only if located outside of incorporated cities, towns, and villages.

(4) The insurer may insure farm machinery wherever located against fire, theft, and upset, or against fire and such additional perils as are usually insured under an extended coverage indorsement.

History:

[41-3104, added 1961, ch. 330, sec. 662, p. 645; am. 1963, ch. 48, sec. 1, p. 199; am. 1969, ch. 211, p. 612; am. 1977, ch. 142, sec. 10, p. 312.]
Idaho Code § 41-2837 — Idaho Code / Title 41 / Chapter 28 / Section 41-2837
41-2837 PROHIBITED PECUNIARY INTEREST OF OFFICIALS.
Status: in_force

41-2837. Prohibited pecuniary interest of officials. (1) Any officer or director, or any member of any committee or an employee of a domestic insurer who is charged with the duty of investing or handling the insurer's funds shall not deposit or invest such funds except in the insurer's corporate name; shall not borrow the funds of such insurer; shall not be pecuniarily interested in any loan, pledge or deposit, security, investment, sale, purchase, exchange, reinsurance, or other similar transaction or property of such insurer except as a stockholder or member; shall not take or receive to his own use any fee, brokerage, commission, gift, or other consideration for or on account of any such transaction made by or on behalf of such insurer.

(2) No insurer shall guarantee any financial obligation of any of its officers or directors.

(3) This section shall not prohibit such a director or officer, or member of a committee or employee from becoming a policyholder of the insurer and enjoying the usual rights so provided for its policyholders, nor shall it prohibit any such officer, director or member of a committee or employee from participating as beneficiary in any pension trust, deferred compensation plan, profit sharing plan or stock option plan authorized by the insurer and to which he may be eligible, nor shall it prohibit any director or member of a committee from receiving a reasonable fee for lawful services actually rendered to such insurer.

(4) The director may, by regulations from time to time, define and permit additional exceptions to the prohibition contained in subsection (1) of this section solely to enable payment of reasonable compensation to a director who is not otherwise an officer or employee of the insurer, or to a corporation or firm in which a director is interested, for necessary services performed or sales or purchases made to or for the insurer in the ordinary course of the insurer's business and in the usual private professional or business capacity of such director or such corporation or firm.

History:

[41-2837, added 1961, ch. 330, sec. 605, p. 645.]
Idaho Code § 41-5401 — Idaho Code / Title 41 / Chapter 54 / Section 41-5401
41-5401 DEFINITIONS.
Status: in_force

41-5401. Definitions. As used in this chapter, these terms shall have the following meanings:

(1) "Adjusted RBC report" means an RBC report which has been adjusted by the director in accordance with section 41-5402(5), Idaho Code.

(2) "Corrective order" means an order issued by the director specifying corrective actions which the director has determined are required.

(3) "Domestic insurer" means any insurer domiciled in this state.

(4) "Foreign insurer" means any insurer not domiciled in this state.

(5) "Health organization" means any hospital service corporation or professional service corporation licensed under chapter 34, title 41, Idaho Code.

(6) "Insurer" means any insurance company authorized to transact insurance business in this state and includes a fraternal benefit society and a health organization unless the context otherwise requires.

(7) "Life and/or health insurer" means any insurer licensed under chapter 3, title 41, Idaho Code, to transact life, disability, accident and/or health insurance and includes any managed care organization within the scope of section 41-3921(1), Idaho Code, or a licensed property and casualty insurer writing only disability or accident and health insurance.

(8) "NAIC" means the national association of insurance commissioners.

(9) "Negative trend" means, with respect to a life and/or health insurer or a fraternal benefit society, a negative trend over a period of time, as determined in accordance with the "Trend Test Calculation" included in the life or fraternal RBC instructions.

(10) "Property and casualty insurer" means any insurer licensed under chapter 3, title 41, Idaho Code, to transact property and casualty insurance, but shall not include monoline mortgage guaranty insurers, financial guaranty insurers, title insurers, farm and county mutuals and domestic reciprocal insurers with fewer than seven (7) subscribers which insure only worker's compensation risk in this state and which only issue fully assessable policies.

(11) "RBC" means risk-based capital.

(12) "RBC instructions" means the RBC report, including risk-based capital instructions adopted by the NAIC, as such RBC instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

(13) "RBC level" means an insurer's company action level RBC, regulatory action level RBC, authorized control level RBC, or mandatory control level RBC where:

(a) "Authorized control level RBC" means the number determined under the risk-based capital formula in accordance with the RBC instructions;

(b) "Company action level RBC" means, with respect to any insurer, the product of 2.0 and its authorized control level RBC;

(c) "Mandatory control level RBC" means the product of .70 and the authorized control level RBC;

(d) "Regulatory action level RBC" means the product of 1.5 and its authorized control level RBC.

(14) "RBC plan" means a comprehensive financial plan containing the elements specified in section 41-5403(2), Idaho Code. If the director rejects the RBC plan and it is revised by the insurer, with or without the director's recommendation, the plan shall be called the "revised RBC plan."

(15) "RBC report" means the report required in section 41-5402, Idaho Code.

(16) "Total adjusted capital" means the sum of:

(a) An insurer's statutory capital and surplus as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed under section 41-335, 41-3225 or 41-3425, Idaho Code; and

(b) Such other items, if any, as the RBC instructions may provide.

History:

[41-5401, added 1996, ch. 96, sec. 1, p. 283; am. 2004, ch. 255, sec. 1, p. 726; am. 2014, ch. 319, sec. 1, p. 785.]
Idaho Code § 41-1807 — Idaho Code / Title 41 / Chapter 18 / Section 41-1807
41-1807 POWER TO CONTRACT — PURCHASE OF INSURANCE BY MINORS.
Status: in_force

41-1807. Power to contract — Purchase of insurance by minors. (1) Any person of competent legal capacity may contract for insurance.

(2) Any minor not less than fifteen (15) years of age, notwithstanding his minority, may contract for annuities or for insurance upon his own life, body, health, property, liabilities or other interests, or on the person of another in whom the minor has an insurable interest. Such a minor shall, notwithstanding such minority, be deemed competent to exercise all rights and powers with respect to or under (a) any contract for annuity or for insurance upon his own life, body or health, or (b) any contract such minor effected upon his own property, liabilities or other interests, or on the person of another, as might be exercised by a person of full legal age, and may at any time surrender his interest in any such contracts and give valid discharge for any benefit accruing or money payable thereunder. Such a minor shall not, by reason of his minority, be entitled to rescind, avoid or repudiate the contract, nor to rescind, avoid or repudiate any exercise of a right or privilege thereunder, except that such a minor not otherwise emancipated, shall not be bound by any unperformed agreement to pay by promissory note or otherwise, any premium on any such annuity or insurance contract.

(3) Any annuity contract or policy of life or disability insurance procured by or for a minor under subsection (2) above, shall be made payable either to the minor or his estate or to a person having an insurable interest in the life of the minor.

History:

[41-1807, added 1961, ch. 330, sec. 399, p. 645; am. 1977, ch. 142, sec. 7, p. 309.]
Idaho Code § 41-1037 — Idaho Code / Title 41 / Chapter 10 / Section 41-1037
41-1037 REQUIREMENTS FOR BAIL AGENTS — FINDINGS — PURPOSE.
Status: in_force

41-1037. Requirements for bail agents — findings — purpose. (1) Sections 41-1037 through 41-1045, Idaho Code, provide requirements for the regulation of bail agents in this state in addition to the requirements generally applicable to producers under this chapter.

(2) The legislature finds that:

(a) Bail agents provide an important local retail service to the retail consumers of bail bonds;

(b) Retail consumers of bail bonds and bail agents require a uniform and consistent regulatory framework that governs retail bail practices; and

(c) There is a need to provide consumer protection from unscrupulous and unfair practices.

(3) The purpose of this chapter is to provide that the department shall uniformly and exclusively license bail agents throughout the state of Idaho and that the department shall regulate such agents and bail transactions, provided the supreme court shall retain its inherent authority to regulate the transaction of bail with the court, including promulgating rules and uniform guidelines.

History:

[41-1037, added 2003, ch. 104, sec. 1, p. 328; am. 2010, ch. 86, sec. 1, p. 165.]
Idaho Code § 41-5602 — Idaho Code / Title 41 / Chapter 56 / Section 41-5602
41-5602 PROMPT PAYMENT OF CLAIMS.
Status: in_force

41-5602. Prompt payment of claims. (1) Except as otherwise specifically provided in this chapter, an insurer shall process a claim for payment for health care services rendered by a practitioner or facility to a beneficiary in accordance with this section.

(2) If a beneficiary, practitioner or facility submits an electronic claim to an insurer within thirty (30) days of the date on which service was delivered, an insurer shall pay or deny the claim not later than thirty (30) days after receipt of the claim.

(3) If a beneficiary, practitioner or facility submits a paper claim for payment to an insurer within forty-five (45) days of the date on which service was delivered, an insurer shall pay or deny the claim not later than forty-five (45) days after receipt of the claim.

(4) If an insurer denies the claim or needs additional information to process the claim, the insurer shall notify the practitioner or facility and the beneficiary in writing within thirty (30) days of receipt of an electronic claim or within forty-five (45) days of receipt of a paper claim. The notice shall state why the insurer denied the claim.

(5) If the claim was denied because more information was required to process the claim, the notice shall specifically describe all information and supporting documentation needed to evaluate the claim for processing. If the practitioner or facility submits the information and documentation identified by the insurer within thirty (30) days of receipt of the written notice, the insurer shall process and pay the claim within thirty (30) days of receipt of the additional information or, if appropriate, deny the claim.

(6) Any claim submitted pursuant to this chapter shall use the current procedural terminology (CPT) code in effect, as published by the American medical association, the international classification of diseases(ICD) code in effect, as published by the United States department of health and human services, or the healthcare common procedural coding system (HCPCS) code in effect, as published by the United States centers for medicare and medicaid services (CMS).

(7) This chapter shall not apply to claims submitted under policies or certificates of insurance for specific disease, hospital confinement indemnity, accident-only, credit, medicare supplement, disability income insurance, student health benefits only coverage issued as a supplement to liability insurance, worker's compensation or similar insurance, automobile medical payment insurance or nonrenewable short-term coverage issued for a period of twelve (12) months or less.

History:

[41-5602, added 2004, ch. 290, sec. 1, p. 813; am. 2005, ch. 66, sec. 1, p. 231; am. 2025, ch. 211, sec. 17, p. 983.]
Idaho Code § 41-1415 — Idaho Code / Title 41 / Chapter 14 / Section 41-1415
41-1415 RATING ORGANIZATIONS — LICENSING.
Status: in_force

41-1415. Rating organizations — Licensing. (1) Any person, corporation, unincorporated association, partnership or individual, whether located within or outside this state, not an officer or employee of any insurer, may apply to the director for a license as a rate making organization for such kinds of insurance or subdivisions or classes of risk or part or combination thereof as are specified in its application. Any property insurance rating bureau licensed under the provisions of this chapter, except a crop hail or nuclear energy insurance rating bureau, shall be entirely independent in its operation and management and shall not be a branch or division of any other property insurance rating bureau. A property insurance rating organization shall establish and maintain a rate making office in this state, and to the extent reasonably possible shall maintain in such office all the files and records relating to the rates currently made by such rating organization and the making thereof; but this provision does not apply as to marine or inland marine or crop hail insurance rating organizations.

(2) As part of its application the rating organization shall file with the director:

(a) Copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its by-laws, rules and regulations governing the conduct of its business;

(b) A list of its members and subscribers;

(c) The name and address of a resident of this state upon whom notices or orders of the director or process affecting the rating organization may be served; and

(d) A statement of its qualifications as a rating organization.

(3) If the director finds that the applicant is competent, trustworthy and otherwise qualified to act as a rating organization, and that its constitution, articles of agreement or association or certificate of incorporation, and its by-laws, rules and regulations governing the conduct of its business conform to the requirements of law, he shall issue a license specifying the kinds of insurance or subdivision or class of risk or part or combination thereof for which the applicant is authorized to act as a rating organization. Every such application shall be granted or denied in whole or in part by the director within sixty (60) days of the date of its filing with him.

History:

[41-1415, added 1961, ch. 330, sec. 320, p. 645; am. 1966 (2nd E.S.), ch. 2, sec. 1, p. 12; am. 1969, ch. 306, sec. 4, p. 917.]
Idaho Code § 41-2003 — Idaho Code / Title 41 / Chapter 20 / Section 41-2003
41-2003 EMPLOYEE GROUPS.
Status: in_force

41-2003. Employee groups. The lives of a group of individuals may be insured under a policy issued to an employer, or to the trustees of a fund established by an employer, which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements:

(1) The employees eligible for insurance under the policy shall be all of the employees of the employer, or all of any class or classes thereof determined by conditions pertaining to their employment. The policy may provide that the term "employees" shall include the employees of one (1) or more subsidiary corporations, and the employees, individual proprietors, and partners of one (1) or more affiliated corporations, proprietors or partnerships if the business of the employer and of such affiliated corporations, proprietors or partnerships is under common control through stock ownership, contract or otherwise. The policy may provide that the term "employees" shall include the individual proprietor or partners if the employer is an individual proprietor or a partnership. The policy may provide that the term "employees" shall include retired employees. No director of a corporate employer shall be eligible for insurance under the policy unless such person is otherwise eligible as a bona fide employee of the corporation, by performing services other than the usual duties of a director. No individual proprietor or partner shall be eligible for insurance under the policy unless he is actively engaged in and devotes a substantial part of his time to the conduct of the business of the proprietor or partnership. A policy issued to insure the employees of a public body may provide that the term "employees" shall include elected or appointed officials.

(2) The premium for the policy shall be paid from the employer's funds or funds contributed by him, from funds contributed by the insured employees, or from both. A policy on which no part of the premium is to be derived from funds contributed by the insured employees must insure all eligible employees, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer, or who have rejected the coverage in writing.

History:

[41-2003, added 1961, ch. 330, sec. 468, p. 645; am. 1971, ch. 122, sec. 9, p. 408; am. 2004, ch. 256, sec. 1, p. 728.]
Idaho Code § 41-3429 — Idaho Code / Title 41 / Chapter 34 / Section 41-3429
41-3429 COMBINED CORPORATION.
Status: in_force

41-3429. Combined corporation. (1) A service corporation may be formed as, or may by suitable amendment of its articles of incorporation become, a combined professional service and hospital service corporation. As to its professional services each such combined service corporation shall fully comply with those provisions of this chapter especially applicable as to professional service corporations; and as to its hospital services the corporation shall fully comply with those provisions of this chapter especially applicable as to hospital service corporations.

(2) Subject to subsection (1) above, nothing in this chapter shall be deemed to prohibit such a combined service corporation from issuing subscriber's contracts providing for both professional services and hospital services.

History:

[41-3429, added 1961, ch. 330, sec. 787, p. 645; am. 1971, ch. 252, sec. 15, p. 1008.]
Idaho Code § 41-2134 — Idaho Code / Title 41 / Chapter 21 / Section 41-2134
41-2134 AGE LIMIT.
Status: in_force

41-2134. Age limit. If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.

History:

[41-2134, added 1961, ch. 330, sec. 523, p. 645.]
Idaho Code § 41-4004 — Idaho Code / Title 41 / Chapter 40 / Section 41-4004
41-4004 PLAN REQUIREMENTS.
Status: in_force

41-4004. Plan requirements. (1) The director shall not register any self-funded plan under this chapter unless the following requirements are met:

(a) The plan must require all contributions to be paid in advance and to be deposited in and disbursed from a trust fund duly created by a written irrevocable trust agreement between the employer or employers and the trustee, or between the postsecondary educational institution and the trustee, that meets the terms of this chapter.

(b) The plan shall appoint a trustee who demonstrates the character, fitness and competence to function in such role and whose function shall be to competently manage and administer the trust fund and plan.

(c) With regard to single employer plans or multiple employer welfare plans, the plans must require that employers contribute to the trust fund and that all contributions by employees, if any, shall be by regular periodic payroll deductions, except as to contributions made by an employee during his absence from such employment for such period as the plan may reasonably provide.

(d) The plan must provide that the trustee shall furnish to each employee-beneficiary or each student-beneficiary a copy of the plan, which shall include a written statement or schedule adequately and clearly stating all benefits currently provided under the plan, as well as all applicable restrictions, limitations, and exclusions, and the procedure for filing a claim for benefits.

(e) The plan shall require that the trust fund be actuarially sound. Assets and income of the trust fund shall at all times be reasonably adequate to provide for full payment of all benefits promised to beneficiaries by the plan and to cover all other costs of operation. The initial contribution rates shall be calculated by a qualified actuary and shall include a reasonable provision for adverse deviation and a reasonable contribution to surplus.

(f) Before the registration by the department of the self-funded plan, the department shall verify that an amount equal to fifty percent (50%) of the qualified actuary's estimate of any minimum surplus requirements, as provided in section 41-4010(3), Idaho Code, after twelve (12) months of operation, be deposited in the trust fund, in addition to the first month's contributions for all beneficiaries.

(2) After registration of the plan, in addition to the required quarterly and annual filings and other requirements as provided in this chapter, the trustee shall file the following documents with the director for his review and approval not less than thirty (30) days before the effective date thereof:

(a) An actuarial study as described in section 41-4005(2)(e), Idaho Code, calculating new rates for the next plan year or more frequent period if there are any midterm rate changes;

(b) Any changes in the policy form, benefits or summary plan description;

(c) Any amendments or changes made to the stop-loss agreement or agreements, including change of carriers;

(d) Any amendments or changes made to administrative, service or management agreements;

(e) Any amendments or changes to the fidelity bond or other coverage the director deemed equivalent pursuant to section 41-4014(3), Idaho Code;

(f) Any amendments or changes to the trust agreement; and

(g) Any change in the trustee or trustees, officers or management of the trust, which notice shall include biographical affidavits of any new trustee, officer or management personnel.

(3) The trustee shall notify the director immediately if the trustee learns or receives information that indicates that the surplus of the trust falls below the minimum surplus requirements.

History:

[41-4004, added 1974, ch. 248, sec. 4, p. 1624; am. 1990, ch. 169, sec. 1, p. 366; am. 2006, ch. 414, sec. 4, p. 1259; am. 2013, ch. 181, sec. 4, p. 422; am. 2019, ch. 306, sec. 2, p. 916.]
Idaho Code § 41-2826 — Idaho Code / Title 41 / Chapter 28 / Section 41-2826
41-2826 AMENDMENT OF ARTICLES OF INCORPORATION — STOCK INSURERS.
Status: in_force

41-2826. Amendment of articles of incorporation — Stock insurers. (1) A domestic stock insurer may amend its articles of incorporation or bylaws for any lawful purpose through procedures prescribed by the statutes of this state as to business corporations in general, and by complying with the requirements of subsection (2) below.

(2) No such amendment to an insurer's articles of incorporation shall be effectuated until a fully executed copy of the certificate of amendments has been filed with the director, and has been approved by him. The director shall approve the amendment unless found by him not to be in compliance with law. At time of filing, the fee therefor shall be paid in the amount prescribed in section 41-401 (fee schedule).

History:

[41-2826, added 1961, ch. 330, sec. 594, p. 645; am. 2004, ch. 239, sec. 1, p. 702.]
Idaho Code § 41-1434 — Idaho Code / Title 41 / Chapter 14 / Section 41-1434
41-1434 HEARING PROCEDURE.
Status: in_force

41-1434. Hearing procedure. (1) An insurer, rating organization, or insurance examining bureau aggrieved by an order or decision of the director made without a hearing, may, within thirty (30) days after notice of the order to the insurer, organization or bureau, make written request to the director for a hearing thereon. The director shall hear such party or parties in accordance with chapter 2, title 41, Idaho Code.

History:

[41-1434, added 1961, ch. 330, sec. 339, p. 645; am. 1969, ch. 306, sec. 11, p. 917; am. 2005, ch. 77, sec. 13, p. 263.]
Idaho Code § 41-2137 — Idaho Code / Title 41 / Chapter 21 / Section 41-2137
41-2137 FRANCHISE DISABILITY INSURANCE LAW.
Status: in_force

41-2137. Franchise Disability Insurance Law. Disability insurance on a franchise plan is hereby declared to be that form of disability insurance issued to:

(1) Four (4) or more employees of any corporation, copartnership, or individual employer or any governmental corporation, agency or department thereof; or

(2) Ten (10) or more members, employees or employees of members of any trade or professional association or of a labor union or of any other association having had an active existence for at least two years where such association or union has a constitution or by-laws and is formed in good faith for purposes other than that of obtaining insurance; where such persons with or without their dependents, are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by such persons under an arrangement whereby the premiums on such policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the association or union for its members, or by some designated person acting on behalf of such employer or association or union. The term "employees" as used herein may be deemed to include the officers, managers and employees and retired employees of the employer and the individual proprietor or partnership.

History:

[41-2137, added 1961, ch. 330, sec. 526, p. 645.]
Idaho Code § 41-726 — Idaho Code / Title 41 / Chapter 7 / Section 41-726
41-726 SPECIAL INVESTMENTS BY TITLE INSURER.
Status: in_force

41-726. Special investments by title insurer. (1) In addition to other investments eligible under this chapter, a title insurer may invest in its abstract plant and equipment, and in loans secured by mortgages on abstract plants and equipment, which plant investment shall not exceed fifty per cent (50%) of its paid-in capital stock and paid-in surplus unless a greater amount is approved in advance by the director. Except with the director's consent, the insurer shall not invest or have invested in stocks of subsidiaries and other corporate stocks an amount in excess of the insurer's surplus funds exclusive of its paid-in capital stock.

(2) In any determination of the insurer's financial condition no investment in abstract plant and equipment, or in loans secured by mortgages thereon, shall be valued at an amount in excess of the lesser of (a) the cost thereof to the insurer, or (b) the fair market value.

(3) No investment as determined in subparagraph (2) above shall be credited against the insurer's unearned premium or loss reserves required under section 41-611, Idaho Code.

History:

[41-726, added 1961, ch. 330, sec. 164, p. 645; am. 1972, ch. 138, sec. 1, p. 305.]
Idaho Code § 41-903 — Idaho Code / Title 41 / Chapter 9 / Section 41-903
41-903 PAYMENT TO ADMINISTRATOR.
Status: in_force

41-903. payment to administrator. If an insurer utilizes the services of an administrator, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured shall be deemed to have been received by the insurer and the payment of return premiums or claims forwarded by the insurer to the administrator shall not be deemed payment to the insured or claimant until the payments are received by the insured or claimant. Nothing in this chapter limits any right of the insurer against the administrator resulting from the failure of the administrator to make payments to the insurer, insured parties or claimants.

History:

[41-903, added 2010, ch. 31, sec. 2, p. 53.]
Idaho Code § 41-323 — Idaho Code / Title 41 / Chapter 3 / Section 41-323
41-323 WHAT CERTIFICATE EVIDENCES — OWNERSHIP OF CERTIFICATE.
Status: in_force

41-323. What certificate evidences — Ownership of certificate. (1) An insurer's subsisting certificate of authority is evidence of its authority to transact in this state the kind or kinds of insurance specified therein, either as direct insurer or as reinsurer or as both.

(2) Although issued to the insurer the certificate of authority is at all times the property of the state of Idaho. Upon any expiration, suspension, or termination thereof the insurer shall promptly deliver the certificate of authority to the director.

History:

[41-323, added 1961, ch. 330, sec. 86, p. 645.]
Idaho Code § 41-1085 — Idaho Code / Title 41 / Chapter 10 / Section 41-1085
41-1085 AUTHORITY OF VENDORS OF PORTABLE ELECTRONICS.
Status: in_force

41-1085. AUTHORITY OF VENDORS OF PORTABLE ELECTRONICS. (1) Notwithstanding any other provision of law, the employees and authorized representatives of vendors may sell or offer portable electronics insurance to customers and shall not be subject to licensure as an insurance producer under the provisions of this chapter provided that:

(a) The vendor obtains a limited lines license to authorize its employees or authorized representatives to sell or offer portable electronics insurance pursuant to the provisions of this section;

(b) The insurer issuing the portable electronics insurance either directly supervises or appoints a supervising entity who shall supervise the administration of the program, to include development of a training program for employees and authorized representatives of the vendors concerning the applicable requirements of this chapter prior to the transaction of any personal electronics insurance. The training required by the provisions of this section shall comply with the following:

(i) The training shall be delivered to employees and authorized representatives of a vendor who are directly engaged in the activity of selling or offering portable electronics insurance;

(ii) The training may be provided in electronic form. However, if conducted in an electronic form, the supervising entity shall implement a supplemental education program regarding the portable electronics insurance product being offered or sold that is conducted and overseen by employees of the supervising entity that are licensed pursuant to this chapter;

(iii) Each employee and authorized representative shall receive basic instruction concerning the portable electronics insurance offered to customers and the disclosures required pursuant to section 41-1084, Idaho Code; and

(c) No employee or authorized representative of a vendor of portable electronics shall advertise, represent or otherwise hold himself out as a limited lines or other licensed insurance producer.

(2) The charges for portable electronics insurance coverage may be billed and collected by the vendor of portable electronics. Any charge to the enrolled customer for portable electronics insurance coverage that is not included in the cost associated with the purchase or lease of portable electronics or related services shall be separately itemized on the enrolled customer's bill. If the portable electronics insurance coverage is included with the purchase or lease of portable electronics or related services, the vendor shall clearly and conspicuously disclose to the enrolled customer that the portable electronics insurance coverage is included in the portable electronics or related services purchased. Vendors billing and collecting such charges shall not be required to maintain such funds in a segregated account, provided that the vendor is authorized by the insurer to hold such funds in a nonsegregated account and is required to remit such amounts to the supervising entity within sixty (60) days of receipt. All funds received by a vendor from an enrolled customer for the sale of portable electronics insurance shall be considered funds held in trust by the vendor in a fiduciary capacity for the benefit of the insurer. Failure to do so is a violation of this section. Vendors may receive compensation for billing and collection services.

History:

[41-1085, added 2012, ch. 226, sec. 7, p. 622.]
Idaho Code § 41-3303 — Idaho Code / Title 41 / Chapter 33 / Section 41-3303
41-3303 DEFINITIONS.
Status: in_force

41-3303. Definitions. For the purposes of this act:

(1) "Ancillary state" means any state other than a domiciliary state.

(2) "Director" means the director of the department of insurance of this state.

(3) "Creditor" is a person having any claim, whether matured or unmatured, liquidated or unliquidated, secured or unsecured, absolute, fixed or contingent.

(4) "Delinquency proceeding" means any proceeding instituted against an insurer for the purpose of liquidating, rehabilitating, reorganizing or conserving such insurer, and any summary proceeding under sections 41-3309 and 41-3310, Idaho Code. "Formal delinquency proceeding" means any liquidation or rehabilitation proceeding.

(5) "Doing business" includes any of the following acts, whether effected by mail or otherwise:

(a) The issuance or delivery of contracts of insurance to persons resident in this state;

(b) The solicitation of applications for such contracts, or other negotiations preliminary to the execution of such contracts;

(c) The collection of premiums, membership fees, assessments, or other consideration for such contracts; or

(d) The transaction of matters subsequent to execution of such contracts and arising out of them.

(e) Operating under a license or certificate of authority, as an insurer, issued by the insurance department.

(6) "Domiciliary state" means the state in which an insurer is incorporated or organized, or, in the case of an alien insurer, its state of entry.

(7) "Fair consideration" is given for property or obligation:

(a) When in exchange for such property or obligation, as a fair equivalent therefor, and in good faith, property is conveyed or services are rendered or an obligation is incurred or an antecedent debt is satisfied; or

(b) When such property or obligation is received in good faith to secure a present advance or antecedent debt in an amount not disproportionately small as compared to the value of the property or obligation obtained.

(8) "Foreign country" means any other jurisdiction not in any state.

(9) "General assets" mean all property, real, personal, or otherwise, not specifically mortgaged, pledged, deposited, or otherwise encumbered for the security or benefit of specified persons or classes of persons. As to specifically encumbered property, "general assets" include all such property or its proceeds in excess of the amount necessary to discharge the sum or sums secured thereby. Assets held in trust and on deposit for the security or benefit of all policyholders or all policyholders and creditors, in more than a single state, shall be treated as general assets.

(10) "Guaranty association" means the Idaho insurance guaranty association created by chapter 36, title 41, Idaho Code, the Idaho life and health insurance guaranty association created by chapter 43, title 41, Idaho Code, and any other similar entity now or hereafter created by the legislature of this state for the payment of claims of insolvent insurers. "Foreign guaranty association" means any similar entities now in existence in or hereafter created by the legislature of any other state.

(11) "Insolvency" or "insolvent" means:

(a) For an insurer issuing only assessable fire insurance policies:

1. The inability to pay any obligation within thirty (30) days after it becomes payable; or

2. If an assessment be made within thirty (30) days after such date, the inability to pay such obligation thirty (30) days following the date specified in the first assessment notice issued after the date of loss.

(b) For any other insurer, that it is unable to pay its obligations when they are due, or when its admitted assets do not exceed its liabilities plus the greater of:

1. Any capital and surplus required by law for its organization; or

2. The total par or stated value of its authorized and issued capital stock.

(c) As to any insurer licensed to do business in this state as of the effective date of this act which does not meet the standard established under paragraph 2, the term "insolvency" or "insolvent" shall mean, for a period not to exceed three (3) years from the effective date of this act, that it is unable to pay its obligations when they are due or that its admitted assets do not exceed its liabilities plus any required capital contribution ordered by the director under provisions of the insurance law.

(d) For purposes of this subsection, "liabilities" shall include, but not be limited to, reserves required by statute or by insurance department general regulations or specific requirements imposed by the director upon a subject company at the time of admission or subsequent thereto.

(12) "Insurer" means any person who has done, purports to do, is doing or is licensed to do an insurance business, and is or has been subject to the authority of, or to liquidation, rehabilitation, reorganization, supervision or conservation by any insurance director. For purposes of this act, any other persons included under section 41-3302, Idaho Code, shall be deemed to be insurers.

(13) "Preferred claim" means any claim with respect to which the terms of this act accord priority of payment from the general assets of the insurer.

(14) "Receiver" means receiver, liquidator, rehabilitator, or conservator as the context requires.

(15) "Reciprocal state" means any state other than this state in which in substance and effect sections 41-3318 (1), 41-3352, 41-3353 and 41-3355 through 41-3357, Idaho Code, are in force, and in which provisions are in force requiring that the director or equivalent official be the receiver of a delinquent insurer, and in which some provision exists for the avoidance of fraudulent conveyances and preferential transfers.

(16) "Secured claim" means any claim secured by mortgage, trust, deed, pledge, deposit as security, escrow, or otherwise, but not including special deposit claims or claims against general assets. The term also includes claims which have become liens upon specific assets by reason of judicial process.

(17) "Special deposit claim" means any claim secured by a deposit made pursuant to statute for the security or benefit of a limited class or classes of persons, but not including any claim secured by general assets.

(18) "State" means any state, district, or territory of the United States and the Panama Canal Zone.

(19) "Transfer" shall include the sale and every other and different mode, direct or indirect, of disposing of or of parting with property or with an interest therein, or with the possession thereof or of fixing a lien upon property or upon an interest therein, absolutely or conditionally, voluntarily, by or without judicial proceedings. The retention of a security title to property delivered to a debtor shall be deemed a transfer suffered by the debtor.

History:

[41-3303, added 1981, ch. 249, sec. 2, p. 504.]
Idaho Code § 41-1838 — Idaho Code / Title 41 / Chapter 18 / Section 41-1838
41-1838 VENUE OF SUITS AGAINST INSURERS.
Status: in_force

41-1838. Venue of suits against insurers. Suit upon causes of action arising within this state against an insurer upon an insurance contract shall be brought in the county where the cause of action arose or in the county where the policy holder instituting such action resides.

History:

[41-1838, added 1961, ch. 330, sec. 430, p. 645.]
Idaho Code § 41-1211 — Idaho Code / Title 41 / Chapter 12 / Section 41-1211
41-1211 SURPLUS LINE LAW — SHORT TITLE — PURPOSE.
Status: in_force

41-1211. Surplus line law — Short title — Purpose. (1) Sections 41-1211 through 41-1234, Idaho Code, constitute and may be cited as the "surplus line law."

(2) It is declared that the purposes of the surplus line law are to provide orderly access for the insuring public of Idaho to insurers not authorized to transact insurance in this state, through only qualified, licensed, and supervised surplus line brokers licensed in Idaho and under such safeguards for the insured as may be practical, for insurance coverages and to the extent thereof not procurable from authorized insurers; to protect such authorized insurers, which under the laws of Idaho must meet certain standards as to policy forms and rates, from unwarranted competition by unauthorized insurers who, in the absence of this law, would not be subject to similar requirements; and for other purposes as set forth in this law.

History:

[41-1211, added 1961, ch. 330, sec. 255, p. 645; am. 1993, ch. 22, sec. 1, p. 79; am. 2002, ch. 91, sec. 1, p. 228.]
Idaho Code § 41-1427 — Idaho Code / Title 41 / Chapter 14 / Section 41-1427
41-1427 EXAMINATION OF INSURERS AND RATING, ADVISORY, JOINT UNDERWRITING, AND JOINT REINSURANCE ORGANIZATIONS.
Status: in_force

41-1427. Examination of insurers and rating, advisory, joint underwriting, and joint reinsurance organizations. (1) As often as he deems necessary, and not less frequently than each five (5) years, the director shall examine each licensed rating organization, each advisory organization, each group, association or other organization of insurers which engages in joint underwriting or joint reinsurance, and each authorized insurer transacting in this state any class of insurance to which the provisions of this chapter are applicable. The examination shall be for the purpose of ascertaining compliance by the person examined with the applicable provisions of this chapter. As to insurers, no such examination requirement shall be satisfied by the periodic examination of the insurer's general affairs.

(2) In lieu of any such examination the director may accept the report of a similar examination made by the insurance supervisory official of another state.

(3) The reasonable cost of the examination shall be paid by the person examined, and such person shall be subject, as though an "insurer," to the provisions of section 41-228, Idaho Code, (examination expense).

(4) Such examination shall also be subject to the applicable provisions of sections 41-223, Idaho Code, (conduct of examination), 41-227, Idaho Code, (examination report), 41-229, Idaho Code, (witnesses and evidence) and 41-230, Idaho Code, (testimony compelled — immunity from prosecution).

History:

[41-1427, added 1961, ch. 330, sec. 332, p. 645; am. 1969, ch. 306, sec. 7, p. 917; am. 2007, ch. 279, sec. 1, p. 810.]
Idaho Code § 41-114 — Idaho Code / Title 41 / Chapter 1 / Section 41-114
41-114 APPLICATION OF CODE AS TO PARTICULAR TYPES OF INSURERS.
Status: in_force

41-114. Application of code as to particular types of insurers. No provision of chapter 1, title 41, Idaho Code, shall apply with respect to:

(1) County mutual insurers (as identified in chapter 31, title 41, Idaho Code), except as stated in chapter 31, title 41, Idaho Code (County Mutual Insurers).

(2) Fraternal benefit societies (as identified in chapter 32, title 41, Idaho Code), except as stated in chapter 32, title 41, Idaho Code (Fraternal Benefit Societies).

(3) Hospital and medical professional service corporations (as identified in chapter 34, title 41, Idaho Code), except as stated in chapter 34, title 41, Idaho Code (Hospital and Professional Service Corporations).

(4) Religious corporations or societies which are exempt from taxation pursuant to section 501(c)(3) of the Internal Revenue Code, as amended, and that provide only first-party property or casualty coverages exclusively to their members.

(5) Any organization described by section 501(c)(3) of the Internal Revenue Code, as amended, but only with respect to the organization's issuance of charitable gift annuities in accordance with the terms of section 41-120, Idaho Code.

History:

[41-114, added 1961, ch. 330, sec. 14, p. 645; am. 1977, ch. 204, sec. 1, p. 556; am. 1984, ch. 253, sec. 1, p. 604; am. 1986, ch. 119, sec. 1, p. 313; am. 1996, ch. 409, sec. 1, p. 1354; am. 2020, ch. 115, sec. 2, p. 365.]
Idaho Code § 41-3106 — Idaho Code / Title 41 / Chapter 31 / Section 41-3106
41-3106 LIMIT OF RISK.
Status: in_force

41-3106. Limit of risk. (1) The maximum amount of insurance which an insurer shall retain as to any one (1) subject of insurance, after deduction of applicable reinsurance, shall not exceed ten per cent (10%) of the insurer's admitted assets or twenty-five thousand dollars ($25,000), whichever is the larger amount.

(2) As to insurance against fire and perils other than windstorm, tornado, hailstorm, and other catastrophic perils, a "subject of insurance" for the purposes of this provision includes all properties insured by the same insurer which are customarily considered by insurance underwriters to be subject to loss or damage from the same fire or the same occurrence of any other peril insured against.

History:

[41-3106, added 1961, ch. 330, sec. 664, p. 645, am. 1978, ch. 109, sec. 1, p. 227.]
Idaho Code § 41-249 — Idaho Code / Title 41 / Chapter 2 / Section 41-249
41-249 SHARING OF INFORMATION AMONG GOVERNMENTAL AGENCIES AND THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS.
Status: in_force

41-249. Sharing of information among governmental agencies and the national association of insurance commissioners. (1) Any document, report, or other recorded information provided to the director by any federal, state or foreign regulatory or law enforcement agency, or any combination thereof, or by the national association of insurance commissioners (NAIC), which is marked "confidential" or "for regulator use only" or by similar terms or concerning which the entity requires written assurance that the director maintain such information in confidence before the entity will release the information, may be maintained by the director on a confidential basis and is not required to be disclosed to the public.

(2) The director may provide any document, report, or other recorded information to any federal, state or foreign regulatory or law enforcement agency, or any combination thereof, or to the NAIC, which is marked "confidential" or "for regulator use only" or by similar terms or concerning which the director requires written assurance that the entity maintain such information in confidence before he will release it to such entity.

(3) The director is authorized to enter into agreements with other governments, agencies, or any combination thereof, or with the NAIC, in connection with his duties and responsibilities pursuant to this section.

(4) The application of this section shall not prevent an insurance company or producer or other licensee from obtaining information used by the department of insurance in making regulatory decisions or taking regulatory action affecting the company consistent with chapter 1, title 74, Idaho Code, and title 41, Idaho Code.

History:

[41-249, added 1994, ch. 309, sec. 1, p. 976; am. 2003, ch. 102, sec. 1, p. 322; am. 2007, ch. 281, sec. 1, p. 812; am. 2015, ch. 141, sec. 106, p. 456.]
Idaho Code § 41-1215 — Idaho Code / Title 41 / Chapter 12 / Section 41-1215
41-1215 BROKER'S AFFIDAVIT.
Status: in_force

41-1215. Broker's affidavit. At the time of procuring any such surplus line insurance the broker shall execute an affidavit, in form as prescribed or accepted by the director, setting forth facts from which it can be determined whether such insurance was eligible for export under section 41-1214, Idaho Code. The broker shall file, or cause to be filed, this affidavit with the director within thirty (30) days after the insurance policy is received by the broker.

History:

[41-1215, added 1961, ch. 330, sec. 259, p. 645; am. 1993, ch. 22, sec. 3, p. 80; am. 2002, ch. 91, sec. 3, p. 228.]
Idaho Code § 41-2709 — Idaho Code / Title 41 / Chapter 27 / Section 41-2709
41-2709 PERSONAL OR CONTROLLED INSURANCE.
Status: in_force

41-2709. Personal or controlled insurance. (1) Personal or controlled insurance means a policy of title insurance where the insured or one (1) of the insureds under such policy is, or the loss thereunder is payable to:

(a) the title insurer issuing such policy or to any person or entity directly or indirectly owning or controlling a majority of the voting stock or ownership in such title insurer, or any entity which is directly or indirectly controlled by a person or entity which also controls the title insurer described in this subsection (a); or

(b) a title insurance agent issuing such policy, or if the agent is a natural person, to his spouse, employer or employer's spouse or such other person related to said persons mentioned within the first degree by blood or marriage, or if the employer is an entity, to any person directly or indirectly owning or controlling the majority of voting stock or ownership of such entity, or any partner or member of an association, and if the agent is an entity, to any person directly or indirectly owning or controlling the majority of the voting stock or ownership of such entity or any corporation which directly or indirectly controls such person who also controls the title insurance agent.

(2) If the rates and charges for personal or controlled insurance in any one (1) year received from any one (1) source by a title insurer or by a title insurance agency exceed twenty-five per cent (25%), or if from all sources of personal and controlled insurance exceed fifty per cent (50%), of the total rates and charges received by such title insurer or title insurance agent in the same year, the excess shall be deemed unlawful rebates. For the purpose of this provision, if the interest of the title insurer or title insurance agent is or was held by the same in a fiduciary capacity for the beneficial owner thereof reflected by a writing between the parties, the issuance of such title insurance policy by which title is conveyed to or by such title insurer or title insurance agent shall not be deemed controlled insurance.

(3) The provisions of sections 41-1310, 41-1311 and 41-1312, Idaho Code, with respect to controlled insurance business shall be deemed to include title insurance as well as the specific types of insurance named therein.

History:

[I.C., sec. 41-2709, as added by 1973, ch. 135, sec. 6, p. 252.]
Idaho Code § 41-2918 — Idaho Code / Title 41 / Chapter 29 / Section 41-2918
41-2918 FINANCIAL CONDITION — METHOD OF DETERMINING.
Status: in_force

41-2918. Financial condition — Method of determining. In determining the financial condition of a reciprocal insurer the director shall apply the following rules:

(1) He shall charge as liabilities the same reserves as are required of incorporated insurers issuing nonassessable policies on a reserve basis.

(2) The surplus deposits of subscribers shall be allowed as assets, except that any premium deposits delinquent for ninety (90) days shall first be charged against such surplus deposit.

(3) The surplus deposits of subscribers shall not be charged as a liability.

(4) All premium deposits delinquent less than ninety (90) days shall be allowed as assets.

(5) An assessment levied upon subscribers, and not collected, shall not be allowed as an asset.

(6) The contingent liability of subscribers shall not be allowed as an asset.

(7) The computation of reserves shall be based upon premium deposits other than membership fees and without any deduction for expenses and the compensation of the attorney.

History:

[41-2918, added 1961, ch. 330, sec. 645, p. 645; am. 1979, ch. 318, sec. 3, p. 855; am. 1995, ch. 96, sec. 7, p. 278; am. 2005, ch. 72, sec. 1, p. 248.]
Idaho Code § 41-2123 — Idaho Code / Title 41 / Chapter 21 / Section 41-2123
41-2123 RELATION OF EARNINGS TO INSURANCE.
Status: in_force

41-2123. Relation of earnings to insurance. (1) There may be a provision as follows:

"Relation of Earnings to Insurance: If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at the time disability commenced or his average monthly earnings for the period of two years immediately preceding disability for which claim is made, whichever is the greater, the insurer will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such two years as shall exceed the pro rata amount of the premiums for the benefits actually paid hereunder; but this shall not operate to reduce the total monthly amount of benefits payable under all such coverage upon the insured below the sum of $200 or the sum of the monthly benefits specified in such coverages, whichever is the lesser, nor shall it operate to reduce benefits other than those payable for loss of time."

(2) The foregoing policy provision may be inserted only in a policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (a) until at least age fifty (50), or (b) in the case of a policy issued after age forty-four (44), for at least five (5) years from its date of issue. The insurer may, at its option, include in this provision a definition of "valid loss of time coverage", approved as to form by the director, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the director or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute (including any workmen's compensation or employer's liability statute), or benefits provided by union welfare plans or by employer or employee benefit organizations.

History:

[41-2123, added 1961, ch. 330, sec. 512, p. 645.]
Idaho Code § 41-1833 — Idaho Code / Title 41 / Chapter 18 / Section 41-1833
41-1833 EXEMPTION OF PROCEEDS — LIFE INSURANCE.
Status: in_force

41-1833. Exemption of proceeds — Life insurance. (1) If a policy of insurance, whether heretofore or hereafter issued, is effected by any person on his own life, or on another life, in favor of a person other than himself, or, except in cases of transfer with intent to defraud creditors, if a policy of life insurance is assigned or in any way made payable to any such person, the lawful beneficiary or assignee thereof, other than the insured or the person so effecting such insurance or executors or administrators of such insured or the person so effecting such insurance, shall be entitled to its proceeds and avails against the creditors and representatives of the insured and of the person effecting the same, whether or not the right to change the beneficiary is reserved or permitted, and whether or not the policy is made payable to the person whose life is insured if the beneficiary or assignee shall predecease such person, and such proceeds and avails shall be exempt from all liability for any debt of the beneficiary existing at the time the policy is made available for his use: provided, that subject to the statute of limitations, the amount of any premiums for such insurance paid with intent to defraud creditors, with interest thereon, shall inure to their benefit from the proceeds of the policy; but the insurer issuing the policy shall be discharged of all liability thereon by payment of its proceeds in accordance with its terms, unless, before such payment, the insurer shall have received written notice at its home office, by or in behalf of a creditor, of a claim to recover for transfer made or premiums paid with intent to defraud creditors, with specification of the amount claimed.

(2) For the purposes of subsection (1) above, a policy shall also be deemed to be payable to a person other than the insured if and to the extent that a facility-of-payment clause or similar clause in the policy permits the insurer to discharge its obligation after the death of the individual insured by paying the death benefits to a person as permitted by such clause.

(3) This section shall not be affected by the terms of section 15-6-107, Idaho Code.

History:

[41-1833, added 1961, ch. 330, sec. 425, p. 645; am. 2003, ch. 248, sec. 1, p. 639.]
Idaho Code § 41-808 — Idaho Code / Title 41 / Chapter 8 / Section 41-808
41-808 EXCESS DEPOSITS.
Status: in_force

41-808. Excess deposits. (1) If securities or assets deposited by an insurer under this chapter are subject to material fluctuations in market value, the director may, in his discretion, require the insurer to deposit and maintain on deposit additional securities or assets in such amount as may be reasonably necessary to assure that the deposit will at all times have a market value of not less than the amount specified under or pursuant to the law by which the deposit is required.

(2) If not so required by the director, an insurer may at its option so deposit assets or securities in an amount exceeding its deposit required or otherwise permitted under this code by not more than twenty per cent (20%) of such required or permitted deposit, or twenty thousand dollars ($20,000), whichever is the larger amount, for the purpose of absorbing fluctuations in the value of securities and assets deposited, and to facilitate the exchange and substitution of such securities and assets. During the solvency of the insurer any such excess shall be released to the insurer upon its request. During the insolvency of the insurer, such excess deposit shall be released only as provided in section 41-812(2)(e).

History:

[41-808, added 1961, ch. 330, sec. 177, p. 645.]
Idaho Code § 41-5413 — Idaho Code / Title 41 / Chapter 54 / Section 41-5413
41-5413 SEVERABILITY.
Status: in_force

41-5413. Severability. The provisions of this act are hereby declared to be severable and if any provision of this act or the application of such provision to any person or circumstance is declared invalid for any reason, such declaration shall not affect the validity of the remaining portions of this act.

History:

[41-5413, added 1996, ch. 96, sec. 1, p. 293.]
Idaho Code § 41-3601 — Idaho Code / Title 41 / Chapter 36 / Section 41-3601
41-3601 SHORT TITLE.
Status: in_force

41-3601. Short title. This act shall be known and may be cited as the "Idaho insurance guaranty association act."

History:

[41-3601, added 1970, ch. 152, sec. 1, p. 462.]
Idaho Code § 41-345 — Idaho Code / Title 41 / Chapter 3 / Section 41-345
41-345 REPORT.
Status: in_force

41-345. Report. (1) Every insurer domiciled in this state shall file a report with the director disclosing material acquisitions and dispositions of assets or material nonrenewals, cancellations or revisions of ceded reinsurance agreements unless such acquisitions and dispositions of assets or material nonrenewals, cancellations or revisions of ceded reinsurance agreements have been submitted to the director for review, approval or information purposes pursuant to other provisions of the insurance code, laws, rules or other requirements.

(2) The report required in subsection (1) of this section is due within fifteen (15) days after the end of the calendar month in which any of the foregoing transactions occur.

(3) One (1) complete copy of the report, including any exhibits or other attachments filed as part thereof, shall be filed with the Idaho department of insurance.

(4) All reports obtained by or disclosed to the director pursuant to sections 41-345 through 41-347, Idaho Code, shall be given confidential treatment and shall not be subject to subpoena and shall not be made public by the director, the national association of insurance commissioners, or any other person, except to insurance departments of other states, without the prior written consent of the insurer to which it pertains unless the director, after giving the insurer who would be affected thereby, notice and an opportunity to be heard, determines that the interest of policyholders, shareholders or the public will be served by the publication thereof, in which event the director may publish all or any part thereof in such manner as he may deem appropriate.

History:

[41-345, added 1995, ch. 68, sec. 1, p. 174; am. 1999, ch. 65, sec. 5, p. 171; am. 2004, ch. 310, sec. 1, p. 871.]
Idaho Code § 41-1207 — Idaho Code / Title 41 / Chapter 12 / Section 41-1207
41-1207 HOW PROCESS IS SERVED — DEFAULT JUDGMENT.
Status: in_force

41-1207. How process is served — Default judgment. (1) Such service of process shall be made as provided for in section 41-334(1), and:

(a) The director shall forthwith mail by registered mail one (1) of the copies of such process to the defendant at its last known principal place of business, and shall keep a record of all processes so served upon him.

(b) Such service of process is sufficient, provided (i) notice thereof and (ii) a copy of the process, are sent to the defendant at its last known principal place of business, by the plaintiff or the plaintiff's attorney, by registered mail within ten (10) days thereafter, and provided that on or before the date the defendant is required to appear, or within such further time as the court may allow, there shall be filed with the clerk of the court in which such action is pending (i) the defendant's receipt of registration, or receipt issued by the post office with which the letter is registered, showing the name of the sender of the letter and the name and address of the person to whom the letter is addressed, and (ii) the affidavit of the plaintiff or plaintiff's attorney showing a compliance herewith.

(2) Service of process in any such action, suit or proceeding shall, in addition to the manner provided in subsection (1) of this section, be valid if served upon any person within this state who, on behalf of such insurer, is:

(a) Soliciting insurance, or

(b) Making, issuing or delivering any contract of insurance, or

(c) Collecting or receiving any premium, membership fee, assessment or other consideration for insurance; and a copy of such process is sent to the defendant in the same manner as set forth in subsection (1)(b) herein.

(3) No plaintiff or complainant shall be entitled to a judgment by default under this section until the expiration of thirty (30) days from the date of the filing of the affidavit of compliance.

(4) Nothing contained in this section shall limit or abridge the right to serve any process, notice or demand upon any insurer in any other manner now or hereafter permitted by law.

History:

[41-1207, added 1961, ch. 330, sec. 251, p. 645.]
Idaho Code § 41-3815 — Idaho Code / Title 41 / Chapter 38 / Section 41-3815
41-3815 SUPERVISORY COLLEGES.
Status: in_force

41-3815. Supervisory colleges. (1) With respect to any insurer registered under section 41-3809, Idaho Code, and in accordance with subsection (3) of this section, the director is authorized to participate in a supervisory college for any domestic insurer that is part of an insurance holding company system with international operations in order to determine compliance by the insurer with this chapter. The powers of the director with respect to supervisory colleges include, but are not limited to, the following:

(a) Initiating the establishment of a supervisory college;

(b) Clarifying the membership and participation of other supervisors in the supervisory college;

(c) Clarifying the functions of the supervisory college and the role of other regulators, including the establishment of a group-wide supervisor;

(d) Coordinating the ongoing activities of the supervisory college, including planning meetings, supervisory activities and processes for information sharing; and

(e) Establishing a crisis management plan.

(2) Each registered insurer subject to this section shall be liable for and shall pay the reasonable expenses of the director's participation in a supervisory college in accordance with subsection (3) of this section, including reasonable travel expenses. For purposes of this section, a supervisory college may be convened as either a temporary or permanent forum for communication and cooperation between the regulators charged with the supervision of the insurer or its affiliates and the director may establish a regular assessment to the insurer for the payment of these expenses.

(3) In order to assess the business strategy, financial position, legal and regulatory position, risk exposure, risk management and governance processes, and as part of the examination of individual insurers in accordance with section 41-3813, Idaho Code, the director may participate in a supervisory college with other regulators charged with supervision of the insurer or its affiliates, including other state, federal and international regulatory agencies. The director may enter into agreements in accordance with section 41-3816(3), Idaho Code, providing the basis for cooperation among the director and the other regulatory agencies, and the activities of the supervisory college. Nothing in this section shall delegate to the supervisory college the authority of the director to regulate or supervise the insurer or its affiliates within its jurisdiction.

History:

[41-3815, added 2013, ch. 266, sec. 2, p. 670.]
Idaho Code § 41-3922 — Idaho Code / Title 41 / Chapter 39 / Section 41-3922
41-3922 TAXATION — PENALTY FOR FAILURE TO FILE.
Status: in_force

41-3922. Taxation — Penalty for failure to file. (1) Each organization offering a managed care plan for which a certificate of authority is required under this chapter shall be subject to taxation as provided in chapter 4, title 41, Idaho Code.

(2) Any managed care organization failing to file any documents required to be filed with the director by this chapter shall be liable to a fine of twenty-five dollars ($25.00) for each day of delinquency. As applicable, the director shall suspend or revoke the certificate of authority of a delinquent managed care organization until the document is filed and the fine, if any, is fully paid.

History:

[(41-3922), added 1974, ch. 177, sec. 28, p. 1444; am. 1978, ch. 9, sec. 2, p. 17; am. 1982, ch. 252, sec. 2, p. 644; am. and redesig. 1997, ch. 204, sec. 25, p. 596.]
Idaho Code § 41-711 — Idaho Code / Title 41 / Chapter 7 / Section 41-711
41-711 CORPORATE OBLIGATIONS.
Status: in_force

41-711. Corporate obligations. An insurer may invest any of its funds in obligations other than those eligible for investment under section 41-721, Idaho Code, (mortgage loans and contracts), if they are issued, assumed, or guaranteed by any solvent institution created or existing under the laws of the United States or of any state, district or territory thereof, or of the government of Canada or any province thereof, and if said institution is not in default as to principal or interest on any of its obligations.

History:

[41-711, added 1961, ch. 330, sec. 148, p. 645; am. 1969, ch. 214, sec. 18, p. 625; am. 1978, ch. 142, sec. 1, p. 322; am. 1983, ch. 189, sec. 3, p. 511.]
Idaho Code § 41-1229 — Idaho Code / Title 41 / Chapter 12 / Section 41-1229
41-1229 TAX ON SURPLUS LINES.
Status: in_force

41-1229. Tax on surplus lines. (1) On or before the first day of March of each year, each broker shall remit to the director a tax on the premiums, exclusive of sums collected to cover federal and state taxes and examination fees, on surplus line insurance subject to tax transacted by him with unauthorized insurers during the preceding calendar year as shown by his annual statement filed with the director, and at the rate of one and five-tenths percent (1.5%). Such tax shall be in lieu of all other taxes upon such insurers with respect to the business so reported.

(2) For property and casualty insurance other than worker's compensation insurance, if Idaho is the insured's home state, then the tax so payable shall be computed upon the entire premium under subsection (1) of this section, without regard to whether the policy covers risks or exposures that are located in Idaho. For all other lines of insurance, if a surplus line policy covers risks or exposures only partially in Idaho, the tax so payable shall be computed upon the proportion of the premium that is properly allocable to the risks or exposures located in Idaho.

(3) Each broker shall round to the nearest whole dollar any amount shown or required to be shown on any return, form, statement, or other document submitted to the director or to any entity set forth in rule pursuant to section 41-1232, Idaho Code. Any record or other document prepared or maintained by the director shall express any dollar amount rounded to the nearest whole dollar.

History:

[41-1229, added 1961, ch. 330, sec. 273, p. 645; am. 1988, ch. 186, sec. 1, p. 325; am. 1988, ch. 366, sec. 4, p. 1079; am. 1994, ch. 383, sec. 3, p. 1232; am. 2004, ch. 387, sec. 1, p. 1163; am. 2011, ch. 183, sec. 5, p. 521; am. 2019, ch. 45, sec. 2, p. 125.]
Idaho Code § 41-224 — Idaho Code / Title 41 / Chapter 2 / Section 41-224
41-224 EXAMINATION — APPRAISAL OF ASSET.
Status: in_force

41-224. Examination — Appraisal of asset. (1) If the director deems it necessary to value any asset involved in such an examination, he may make written request of the person being examined to appoint one or more appraisers who by reason of education, experience or special training are competent to appraise such asset. Any such appraiser shall be subject to the written approval of the director. If no such appointment is made within ten (10) days after the request therefor was delivered to such person, the director may appoint the appraiser or appraisers.

(2) Any such appraisal shall be promptly made, and a copy of the report thereof shall be furnished to the director.

(3) The reasonable expense of the appraisal shall be borne by the person being examined.

History:

[41-224, added 1961, ch. 330, sec. 41, p. 645.]
Idaho Code § 41-102 — Idaho Code / Title 41 / Chapter 1 / Section 41-102
41-102 “INSURANCE” DEFINED.
Status: in_force

41-102. "Insurance" defined. "Insurance" is a contract whereby one undertakes to indemnify another or pay or allow a specified or ascertainable amount or benefit upon determinable risk contingencies.

History:

[41-102, added 1961, ch. 330, sec. 2, p. 645.]
Idaho Code § 41-254 — Idaho Code / Title 41 / Chapter 2 / Section 41-254
41-254 POWERS AND DUTIES OF STATE FIRE MARSHAL — INTERNATIONAL FIRE CODE, ENFORCEMENT AND REGULATIONS — REPORTS.
Status: in_force

41-254. Powers and duties of state fire marshal — International fire code, enforcement and regulations — Reports. The state fire marshal shall be appointed by the director of the department of insurance, with the approval of the governor and shall serve at the pleasure of the director. The state fire marshal shall have the following powers and duties:

1. To enforce the international fire code.

2. To prescribe regulations in addition to the international fire code as adopted, which may be deemed necessary for the prevention of fires and protection of life and property, and such regulations are to be enforced by the state fire marshal.

3. To make interpretations and rules of the intent of the various provisions of the international fire code as adopted.

4. To adopt, rescind, modify or amend rules and regulations for the exercise of functional powers and duties.

5. To transmit to the governor and legislature, on or before the 15th day of July of every year, a full report of proceedings under sections 41-253 through 41-269, Idaho Code, and such statistics as he may wish to include therein unless some other time for reporting is fixed by law, and such report shall be available to the public.

6. To make recommendations for amendments to the international fire code to be submitted to the promulgating authority for its consideration.

7. To have exclusive jurisdiction over single service integrated fire sprinkler systems. A "single service integrated fire sprinkler system" is defined as an integrated system of underground and overhead piping, valves and sprinklers used exclusively for fire protection purposes and designed in accordance with fire protection engineering standards, including the international fire code, beginning with the first connection to a public water system regardless of the existence or location of a back flow prevention device.

8. No person shall be eligible to serve as state fire marshal unless he:

(a) Has had at least twelve (12) years' full-time paid experience with a state, city or county fire protection agency whose primary function is fire prevention and structural fire safety, including at least five (5) years' experience in an administrative capacity as the chief agency officer; or

(b) Holds a four (4) year college degree in one of the physical sciences and has had at least five (5) years' full-time experience in fire protection and structural fire safety with a fire protection agency; or

(c) Is a member of the American society of fire protection engineers.

History:

[(41-254) 1970, ch. 190, sec. 4, p. 547; am. 1974, ch. 39, sec. 45, p. 1023; am. and redesig. 1982, ch. 120, sec. 2, p. 338; am. 1993, ch. 43, sec. 1, p. 115; am. 1993, ch. 128, sec. 2, p. 323; am. 2002, ch. 86, sec. 6, p. 198.]
Idaho Code § 41-2127 — Idaho Code / Title 41 / Chapter 21 / Section 41-2127
41-2127 INTOXICANTS AND NARCOTICS.
Status: in_force

41-2127. Intoxicants and narcotics. There may be a provision as follows:

"Intoxicants and Narcotics: The insurer shall not be liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of any narcotic unless administered on the advice of a physician."

History:

[41-2127, added 1961, ch. 330, sec. 516, p. 645.]
Idaho Code § 41-1501 — Idaho Code / Title 41 / Chapter 15 / Section 41-1501
41-1501 SHORT TITLE.
Status: in_force

41-1501. Short title. This chapter will be known and may be cited as the "Managing General Agents Act."

History:

[41-1501, added 1991, ch. 293, sec. 1, p. 754.]
Idaho Code § 41-4941 — Idaho Code / Title 41 / Chapter 49 / Section 41-4941
41-4941 PENALTIES.
Status: in_force

41-4941. Penalties. (1) Any person who willfully violates or causes or induces a violation of any provision of this chapter or any lawful rule of the director issued thereunder, shall be subject to penalty as provided in subsection (4) of this section.

(2) Any person who makes a false statement or representation of a material fact, knowing it to be false, or who knowingly fails to disclose a material fact in any application, examination, or statement required under this act or by lawful rule of the director thereunder, shall be subject to penalty as provided in subsection (4) of this section.

(3) Any person who makes a false entry in any book, record, statement, or report required in this chapter or lawful rule of the director thereunder to be kept by him, with intent to injure or defraud the trust fund or any member thereof, or to deceive anyone authorized or entitled to examine the affairs of the trust fund, shall be subject to penalty as provided in subsection (4) of this section.

(4) For each such violation, act or omission referred to in this section, unless greater penalty is provided therefor under any other applicable law, the offender shall upon conviction thereof be subject to a fine of not more than one thousand dollars ($1,000) and to imprisonment for not more than one (1) year, or to both such fine and imprisonment.

History:

[(41-4941) 41-4944, added 1990, ch. 119, sec. 1, p. 289; am. & redesig. 2003, ch. 96, sec. 45, p. 308.]
Idaho Code § 41-5107 — Idaho Code / Title 41 / Chapter 51 / Section 41-5107
41-5107 REQUIRED CONTRACT PROVISIONS — REINSURANCE INTERMEDIARY — MANAGERS.
Status: in_force

41-5107. Required contract provisions — Reinsurance intermediary — Managers. Transactions between a RM and the reinsurer it represents in such capacity shall only be entered into pursuant to a written contract, specifying the responsibilities of each party, which shall be approved by the reinsurer's board of directors. At least thirty (30) days before such reinsurer assumes or cedes business through such producer, a true copy of the approved contract shall be filed with the director for approval. The contract shall, at a minimum, contain provisions that:

(1) The reinsurer may terminate the contract for cause upon written notice to the RM. The reinsurer may immediately suspend the authority of the RM to assume or cede business during the pendency of any dispute regarding the cause for termination.

(2) The RM will render accounts to the reinsurer accurately detailing all material transactions, including information necessary to support all commissions, charges and other fees received by, or owing to the RM, and remit all funds due under the contract to the reinsurer on not less than a monthly basis.

(3) All funds collected for the reinsurer's account will be held by the RM in a fiduciary capacity in a bank which is a qualified United States financial institution as defined herein. The RM may retain no more than three (3) months estimated claims payments and allocated loss adjustment expenses. The RM shall maintain a separate bank account for each reinsurer that it represents.

(4) For at least ten (10) years after expiration of each contract of reinsurance transacted by the RM, the RM will keep a complete record for each transaction showing:

(a) The type of contract, limits, underwriting restrictions, classes or risks and territory;

(b) Period of coverage, including effective and expiration dates, cancellation provisions and notice required of cancellation, and disposition of outstanding reserves on covered risks;

(c) Reporting and settlement requirements of balances;

(d) Rate used to compute the reinsurance premium;

(e) Names and addresses of reinsurers;

(f) Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the RM;

(g) Related correspondence and memoranda;

(h) Proof of placement;

(i) Details regarding retrocessions handled by the RM, as permitted under the provisions of section 41-5109(4), Idaho Code, including the identity of retrocessionaires and percentage of each contract assumed or ceded;

(j) Financial records including, but not limited to, premium and loss accounts; and

(k) When the RM places a reinsurance contract on behalf of a ceding insurer:

(i) Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or

(ii) If placed through a representative of the assuming reinsurer, other than an employee, written evidence that such reinsurer has delegated binding authority to the representative.

(5) The reinsurer will have access and the right to copy all accounts and records maintained by the RM related to its business in a form usable by the reinsurer.

(6) The contract cannot be assigned in whole or in part by the RM.

(7) The RM will comply with the written underwriting and rating standards established by the insurer for the acceptance, rejection or cession of all risks.

(8) Set forth the rates, terms and purposes of commissions, charges and other fees which the RM may levy against the reinsurer.

(9) If the contract permits the RM to settle claims on behalf of the reinsurer:

(a) All claims will be reported to the reinsurer in a timely manner;

(b) A copy of the claim file will be sent to the reinsurer at its request or as soon as it becomes known that the claim:

(i) Has the potential to exceed the lesser of an amount determined by the director or the limit set by the reinsurer;

(ii) Involves a coverage dispute;

(iii) May exceed the RM's claims settlement authority;

(iv) Is open for more than six (6) months; or

(v) Is closed by payment of the lesser of an amount set by the director or an amount set by the reinsurer;

(c) All claim files will be the joint property of the reinsurer and the RM. However, upon an order of liquidation of the reinsurer such files shall become the sole property of the reinsurer or its estate. The RM shall have reasonable access to and the right to copy the files on a timely basis; and

(d) Any settlement authority granted to the RM may be terminated for cause upon the reinsurer's written notice to the RM or upon the termination of the contract. The reinsurer may suspend the settlement authority during the pendency of the dispute regarding the cause of termination.

(10) If the contract provides for a sharing of interim profits by the RM, such interim profits will not be paid until one (1) year after the end of each underwriting period for property business and five (5) years after the end of each underwriting period for casualty business (or a later period set by the director for specified lines of insurance) and not until the adequacy of reserves on remaining claims has been verified pursuant to section 41-5109(3), Idaho Code.

(11) The RM will annually provide the reinsurer with a statement of its financial condition prepared by an independent certified accountant.

(12) The reinsurer shall periodically (at least semiannually) conduct an onsite review of the underwriting and claims processing operations of the RM.

(13) The RM will disclose to the reinsurer any relationship it has with any insurer prior to ceding or assuming any business with such insurer pursuant to this contract.

(14) Within the scope of its actual or apparent authority the acts of the RM shall be deemed to be the acts of the reinsurer on whose behalf it is acting.

History:

[41-5107, added 1992, ch. 82, sec. 1, p. 252.]
Idaho Code § 41-2840 — Idaho Code / Title 41 / Chapter 28 / Section 41-2840
41-2840 VOUCHERS FOR EXPENDITURES.
Status: in_force

41-2840. Vouchers for expenditures. (1) No insurer shall make any disbursement of twenty-five dollars ($25) or more, unless evidenced by a voucher or other document correctly describing the consideration for the payment and supported by a check or receipt endorsed or signed by or on behalf of the person receiving the money.

(2) If the disbursement is for services and reimbursement, the voucher or other document, or some other writing referred to therein, shall describe the services and itemize the expenditures.

(3) If the disbursement is in connection with any matter pending before any legislature or public body or before any public official, the voucher or other document shall also correctly describe the nature of the matter and of the insurer's interest therein.

History:

[41-2840, added 1961, ch. 330, sec. 608, p. 645.]
Idaho Code § 41-1204 — Idaho Code / Title 41 / Chapter 12 / Section 41-1204
41-1204 UNAUTHORIZED INSURERS PROCESS ACT — TITLE — INTERPRETATION.
Status: in_force

41-1204. Unauthorized insurers process act — Title — Interpretation. (1) Sections 41-1204 through 41-1210 constitute and may be cited as the Unauthorized Insurers Process Act.

(2) Such act shall be so interpreted as to effectuate its general purpose to make uniform the law of those states which enact it.

History:

[41-1204, added 1961, ch. 330, sec. 248, p. 645.]
Idaho Code § 41-3104A — Idaho Code / Title 41 / Chapter 31 / Section 41-3104A
41-3104A PROPERTY USED TO FIGHT FIRES — CHARGES.
Status: in_force

41-3104A. Property used to fight fires — Charges. Any county mutual fire insurer may acquire and dispose of real and personal property necessary to prevent, abate or extinguish fires.

Non-discriminatory, reasonable charges based on insurable value, as approved by the director, may be assessed against any owner who has received services from a county mutual fire insurer to prevent, abate or extinguish fires.

Activities authorized under this section shall not necessarily be limited to members or to the insurer's territory.

History:

[I.C., sec. 41-3104A, as added by 1972, ch. 143, sec. 1, p. 310.]
Idaho Code § 41-115 — Idaho Code / Title 41 / Chapter 1 / Section 41-115
41-115 PARTICULAR PROVISIONS PREVAIL.
Status: in_force

41-115. Particular provisions prevail. Provisions of this code relative to a particular kind of insurance or a particular type of insurer or to a particular matter shall prevail over provisions relating to insurance in general or insurers in general or to such matter in general.

History:

[41-115, added 1961, ch. 330, sec. 15, p. 645.]
Idaho Code § 41-5406 — Idaho Code / Title 41 / Chapter 54 / Section 41-5406
41-5406 MANDATORY CONTROL LEVEL EVENT.
Status: in_force

41-5406. Mandatory control level event. (1) "Mandatory control level event" means any of the following events:

(a) The filing of an RBC report that indicates that the insurer's total adjusted capital is less than its mandatory control level RBC;

(b) Notification by the director to the insurer of an adjusted RBC report that indicates the event in paragraph (a) of this subsection, provided the insurer does not challenge the adjusted RBC report under section 41-5407, Idaho Code; or

(c) If, pursuant to section 41-5407, Idaho Code, the insurer challenges an adjusted RBC report that indicates the event in paragraph (a) of this subsection, notification by the director to the insurer that the director has, after a hearing, rejected the insurer's challenge.

(2) In the event of a mandatory control level event:

(a) With respect to a life and/or health insurer that completes the life annual statement for the reporting year or fraternal benefit society, the director shall take such actions as are necessary to place the insurer under regulatory control pursuant to chapter 33, title 41, Idaho Code. In that event, the mandatory control level event shall be deemed sufficient grounds for the director to take action pursuant to chapter 33, title 41, Idaho Code, and the director shall have the rights, powers and duties with respect to the insurer as are set forth in chapter 33, title 41, Idaho Code. If the director takes actions pursuant to an adjusted RBC report, the insurer shall be entitled to the protections of section 41-3309, Idaho Code, pertaining to summary proceedings. Notwithstanding any of the foregoing, the director may forgo action for up to ninety (90) days after the mandatory control level event if the director finds there is a reasonable expectation that the mandatory control level event may be eliminated within the ninety (90) day period.

(b) With respect to a property and casualty insurer, health organization or health insurer that completes the health annual statement for the reporting year, the director shall take such actions as are necessary to place the insurer under regulatory control pursuant to chapter 33, title 41, Idaho Code, or, in the case of an insurer which is writing no business and which is running off its existing business, may allow the insurer to continue its run off under the supervision of the director. In either event, the mandatory control level event shall be deemed sufficient grounds for the director to take action pursuant to chapter 33, title 41, Idaho Code, and the director shall have the rights, powers and duties with respect to the insurer as are set forth in chapter 33, title 41, Idaho Code. If the director takes actions pursuant to an adjusted RBC report, the insurer shall be entitled to the protections of section 41-3309, Idaho Code, pertaining to summary proceedings. Notwithstanding any of the foregoing, the director may forgo action for up to ninety (90) days after the mandatory control level event if the director finds there is a reasonable expectation that the mandatory control level event may be eliminated within the ninety (90) day period.

History:

[41-5406, added 1996, ch. 96, sec. 1, p. 289; am. 2014, ch. 319, sec. 4, p. 788.]
Idaho Code § 41-3928 — Idaho Code / Title 41 / Chapter 39 / Section 41-3928
41-3928 INCENTIVES TO WITHHOLD CARE PROHIBITED.
Status: in_force

41-3928. Incentives to withhold care prohibited. (1) No managed care organization shall offer a provider and no contract between a managed care organization and a provider shall contain any incentive plan that includes a specific payment made, in any type or form, to the provider as an inducement to deny, reduce, limit, or delay specific, medically necessary, and appropriate services covered by the health care contract and provided with respect to a specific member or group of members with similar medical conditions.

(2) Nothing in this section shall be construed to prohibit contracts that contain incentive plans that involve general payments such as capitation payments or shared risk agreements that are not tied to specific medical decisions involving specific members or groups of members with similar medical conditions.

History:

[41-3928, added 1997, ch. 204, sec. 31, p. 601.]
Idaho Code § 41-3208 — Idaho Code / Title 41 / Chapter 32 / Section 41-3208
41-3208 NO PERSONAL LIABILITY.
Status: in_force

41-3208. No personal liability. (1) The officers and members of the supreme governing body or any subordinate body of a society shall not be personally liable for any benefits provided by a society.

(2) Any person may be indemnified and reimbursed by any society for expenses reasonably incurred by, and liabilities imposed upon, such person in connection with or arising out of any action, suit or proceeding, whether civil, criminal, administrative or investigative, or threat thereof, in which the person may be involved by reason of the fact that the person is or was a director, officer, employee or agent of the society or of any firm, corporation or organization which he served in any capacity at the request of the society. A person shall not be so indemnified or reimbursed: (a) in relation to any matter in such action, suit or proceeding as to which he shall finally be adjudged to be or have been guilty of breach of a duty as a director, officer, employee or agent of the society; or (b) in relation to any matter in such action, suit or proceeding, or threat thereof, which has been made the subject of a compromise settlement; unless in either such case the person acted in good faith for a purpose the person reasonably believed to be in or not opposed to the best interests of the society and, in a criminal action or proceeding, in addition, had no reasonable cause to believe that his conduct was unlawful. The determination whether the conduct of such person met the standard required in order to justify indemnification and reimbursement in relation to any matter described in subpoints (a) or (b) of the preceding sentence may only be made by the supreme governing body or board of directors by a majority vote of a quorum consisting of persons who were not parties to such action, suit or proceeding or by a court of competent jurisdiction. The termination of any action, suit or proceeding by judgment, order, settlement, conviction, or upon a plea of no contest, as to such person shall not in itself create a conclusive presumption that the person did not meet the standard of conduct required in order to justify indemnification and reimbursement. The foregoing right of indemnification and reimbursement shall not be exclusive of other rights to which such person may be entitled as a matter of law and shall inure to the benefit of his heirs, executors and administrators.

(3) A society shall have power to purchase and maintain insurance on behalf of any person who is or was a director, officer, employee or agent of the society, or who is or was serving at the request of the society as a director, officer, employee or agent of any other firm, corporation, or organization against any liability asserted against such person and incurred by him in any such capacity or arising out of his status as such, whether or not the society would have the power to indemnify the person against such liability under this section.

(4) No director, officer, employee, member or volunteer of a society serving without compensation, shall be liable, and no cause of action may be brought, for damages resulting from the exercise of judgment or discretion in connection with the duties or responsibilities of such person for the society unless such act or omission involved willful or wanton misconduct.

History:

[41-3208, added 1995, ch. 213, sec. 2, p. 726.]
Idaho Code § 41-295 — Idaho Code / Title 41 / Chapter 2 / Section 41-295
41-295 DUTIES OF THE INVESTIGATION SECTION.
Status: in_force

41-295. Duties of the investigation section. The investigation section of the department of insurance shall have the following duties:

(1) To conduct civil or criminal investigations within or outside this state as deemed necessary to determine whether any person has violated any provision of title 41, Idaho Code.

(2) For purposes of any investigation under this code, the director, or any officer designated by him, may administer oaths and affirmations, subpoena bank records, subpoena witnesses and compel their attendance, take evidence, and require the production of any books, papers, correspondence, memoranda, agreements, or other documents the director deems relevant or material to the investigation.

(3) The investigation section shall furnish all papers, documents, reports, complaints, or other facts of evidence to any police, sheriff or other law enforcement agency, when so requested, and will assist and cooperate with such law enforcement agencies.

(4) The investigation section shall refer criminal violations of the code to the attorney general, county prosecutor, or other prosecutor having jurisdiction of any such violation. The attorney general, county prosecutor, or other prosecutor shall promptly institute and prosecute such action or proceedings against such person as the information may require or justify. Whoever is the prosecuting attorney of record shall have exclusive authority in all matters regarding such action or proceeding.

(5) The investigation section shall have such other duties as the director of the department of insurance shall assign or as contained elsewhere in title 41, Idaho Code.

(6) The investigation section shall be permitted to seek court ordered restitution as reimbursement, for the cost of investigation from those individuals successfully prosecuted under section 41-293, Idaho Code. Any restitution payments received pursuant to this section shall be deposited in the insurance administrative account as provided in section 41-401, Idaho Code.

History:

[41-295, added 1994, ch. 219, sec. 7, p. 700; am. 1997, ch. 122, sec. 4, p. 369; am. 2005, ch. 74, sec. 3, p. 253.]
Idaho Code § 41-4011 — Idaho Code / Title 41 / Chapter 40 / Section 41-4011
41-4011 RECORDS AND ACCOUNTS — ANNUAL STATEMENT.
Status: in_force

41-4011. Records and accounts — Annual statement. (1) The trustee of a self-funded plan shall cause full and accurate records and accounts to be entered and maintained during all times of the existence of the trust covering all financial transactions and affairs of the trust fund, which records and accounts shall be subject to review by the director. Any audit of the plan or trust shall be completed independently of any other entity.

(2) Within ninety (90) days after close of a fiscal year of the plan, the trustee shall prepare an annual statement in writing summarizing the financial transactions of the trust fund for such fiscal year and the financial condition of the trust at the end of such year in accordance with the requirements of this chapter and with generally accepted accounting principles. The statement shall be in a form acceptable to the director and include such information as prescribed by the director. The financial information included therein shall be certified by the accountant who audited such information. The trustee shall promptly deliver a copy of the statement to each employer or postsecondary educational institution participating in the plan and keep a copy thereof on file in the business office from which the plan is operated. Such statement shall be available for review by any beneficiary at all reasonable times for a period of not less than three (3) years from the date of the statement. If the plan is managed by a third party administrator, such statement shall be available at the administrative offices of the employer or employers or postsecondary educational institution.

(3) The plan's annual statement shall be accompanied by the certified actuarial opinion described in section 41-4010, Idaho Code. Such annual statement shall be prepared in accordance with actuarial standard of practice no. 28. The self-funded plan shall require that the qualified actuary retain the actuarial work papers until the department has filed an examination report of the plan covering the period of the actuarial opinion but no longer than seven (7) years from the date of such opinion.

(4) On or before expiration of such ninety (90) day period the trustee shall file an original of the annual statement and certified actuarial opinion with the director. The actuarial opinion shall be filed in a form prescribed by the director. The trustee shall pay a filing fee as provided for by rule. The director may grant a thirty (30) day extension of the time for filing the annual statement.

(5) The trustee shall also file quarterly supplemental unaudited financial reports and other periodic supplemental unaudited financial reports in a form and at the times prescribed by the director.

(6) The director shall transmit and account for all fees received by him hereunder as provided in section 41-406, Idaho Code.

(7) The annual and quarterly reports required under this section are public records and are available to the public, notwithstanding the exemptions from disclosure provided in chapter 1, title 74, Idaho Code.

History:

[41-4011, added 1974, ch. 248, sec. 11, p. 1624; am. 1984, ch. 23, sec. 13, p. 45; am. 2006, ch. 414, sec. 10, p. 1264; am. 2010, ch. 96, sec. 2, p. 184; am. 2013, ch. 181, sec. 11, p. 428; am. 2015, ch. 141, sec. 113, p. 463.]
Idaho Code § 41-1809 — Idaho Code / Title 41 / Chapter 18 / Section 41-1809
41-1809 ALTERATION OF APPLICATION — LIFE AND DISABILITY INSURANCE.
Status: in_force

41-1809. Alteration of application — Life and disability insurance. No alteration of any written application for any life or disability insurance policy shall be made by any person other than the applicant without his written consent, except that insertions may be made by the insurer, for administrative purposes only, in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.

History:

[41-1809, added 1961, ch. 330, sec. 401, p. 645.]
Idaho Code § 41-5210 — Idaho Code / Title 41 / Chapter 52 / Section 41-5210
41-5210 APPLICATION TO BECOME A RISK-ASSUMING CARRIER.
Status: in_force

41-5210. Application to become a risk-assuming carrier. (1) An individual carrier may apply to become a risk-assuming carrier by filing an application with the director in a form and manner prescribed by the director.

(2) The director shall consider the following factors in evaluating an application filed under the provisions of subsection (1) of this section:

(a) The carrier's financial condition;

(b) The carrier's history of rating and underwriting individuals;

(c) The carrier's commitment to market fairly to all individuals in the state or its established geographic service area, as applicable;

(d) The carrier's experience with managing the risk of individuals; and

(e) The extent to which a carrier has and will be able to maintain reinsurance pursuant to the provisions of subsection (3) of section 41-5204, Idaho Code.

(3) The director shall provide public notice of an application by an individual carrier to be a risk-assuming carrier and shall provide at least a sixty (60) day period for public comment prior to making a decision on the application. If the application is not acted on within ninety (90) days of the receipt of the application by the director, the carrier may request a hearing.

(4) The director may rescind the approval granted to a risk-assuming carrier under the provisions of this section if the director finds that:

(a) The carrier's financial condition will no longer support the assumption of risk from issuing coverage to individuals in compliance with the provisions of section 41-5208, Idaho Code, without the protection afforded by the program;

(b) The carrier has failed to market fairly to all individuals in the state or its established geographic service area, as applicable; or

(c) The carrier has failed to provide coverage to eligible individuals as required in section 41-5208, Idaho Code.

History:

[41-5210, added 1994, ch. 427, sec. 1, p. 1347; am. 2025, ch. 49, sec. 12, p. 253.]
Idaho Code § 41-5905 — Idaho Code / Title 41 / Chapter 59 / Section 41-5905
41-5905 NOTICE OF RIGHT TO EXTERNAL REVIEW.
Status: in_force

41-5905. notice of right to external review. (1) When a final adverse benefit determination is made, the health carrier shall notify the covered person in writing of the covered person's right to request an external review to be conducted pursuant to section 41-5908, 41-5909 or 41-5910, Idaho Code, and include the appropriate statements and information set forth in subsection (2) of this section at the same time the health carrier sends written notice of the final adverse benefit determination.

(2) The director may prescribe by rule the form and content of the notice required under this section, which shall include:

(a) The following, or substantially equivalent, language:

"We have denied your request for the provision of or payment for a health care service or course of treatment. You may have the right to have our decision reviewed by health care professionals who have no association with us if our decision involved making a judgment as to the medical necessity, appropriateness, health care setting, level of care or effectiveness of your health care service or supply, or your health care service or supply was denied based upon a determination that it was investigational. You may request an external review by submitting a written request to the department of insurance."

The notice shall include contact information for the department of insurance, including the website, address and telephone number.

(b) If the adverse benefit determination is for a pre-service or concurrent service, the health carrier shall notify the covered person of the right to an expedited external review if the request is an urgent care request. The notification shall include the definition of urgent care request.

(c) The health carrier shall include a copy of the description of both the standard and expedited external review procedures the health carrier is required to provide pursuant to section 41-5916, Idaho Code, highlighting the provisions in the external review procedures that give the covered person the opportunity to submit additional information, and include any forms used to process an external review.

(d) The health carrier shall include an authorization form, or other document approved by the director, that complies with the requirements of 45 CFR section 164.508, by which the covered person, for purposes of conducting an external review pursuant to this chapter, authorizes the health carrier and the covered person's treating health care providers to disclose protected health information, including medical records, concerning the covered person that are pertinent to the external review. Until the director receives this form from the covered person, duly executed, the external review process is stayed and the health carrier has no obligations under this chapter.

History:

[41-5905, added 2009, ch. 87, sec. 1, p. 245; am. 2011, ch. 122, sec. 3, p. 338.]
Idaho Code § 41-5209 — Idaho Code / Title 41 / Chapter 52 / Section 41-5209
41-5209 NOTICE OF INTENT TO OPERATE AS A RISK-ASSUMING CARRIER OR A REINSURING CARRIER.
Status: in_force

41-5209. Notice of intent to operate as a risk-assuming carrier or a reinsuring carrier. (1) (a) Each individual carrier shall notify the director within thirty (30) days of the effective date of this chapter of the carrier's intention to operate as a risk-assuming carrier or a reinsuring carrier. An individual carrier seeking to operate as a risk-assuming carrier shall make an application pursuant to the provisions of section 41-5210, Idaho Code.

(b) The decision shall be binding for a five (5) year period except that the initial decision shall be binding for two (2) years. The director may permit a carrier to modify its decision at any time for good cause shown.

(c) The director shall establish an application process for individual carriers seeking to change their status under the provisions of this subsection.

(2) A reinsuring carrier that applies and is approved to operate as a risk-assuming carrier shall not be permitted to continue to reinsure any health benefit plan with the program. Such a carrier shall pay a prorated assessment based upon business issued as a reinsuring carrier for any portion of the year that the business was reinsured.

History:

[41-5209, added 1994, ch. 427, sec. 1, p. 1346.]
Idaho Code § 41-2606 — Idaho Code / Title 41 / Chapter 26 / Section 41-2606
41-2606 PREMIUMS ON BONDS — ALLOWANCE AS EXPENSE COSTS — LIMIT AS TO AMOUNT.
Status: in_force

41-2606. Premiums on bonds — Allowance as expense costs — Limit as to amount. (1) Any assignee, receiver, trustee, committee, guardian, curator, executor, administrator or other fiduciary required as such by law or the order of any court or judge to give bond or undertaking, may include as a part of the lawful expense of executing his trust such sum, paid to a surety insurer or to surety insurers authorized under the laws of this state to do so for becoming his surety on such bond or undertaking, as may be allowed by the court in which, or a judge before whom, he is required to account; and such court or judge shall allow in the settlement of the account of any such fiduciary the premium or premiums so paid to any such insurer or insurers, but not to exceed the premium for such bond or undertaking filed by such insurer or insurers with the director.

(2) In all other cases where, by the provisions of law, a corporate surety or guarantor is given or required as to an official bond except as to notaries public, the premium to be paid to any such insurer or insurers for becoming such surety or guarantor shall be paid out of the general funds of the divisions of government by or for which the person or persons covered by such bond or undertaking was appointed or elected, but the premiums shall in no case exceed the premiums filed by such insurer or insurers with the director for the individual, schedule or blanket bonds given or required.

History:

[41-2606, added 1961, ch. 330, sec. 559, p. 645.]
Idaho Code § 41-3311 — Idaho Code / Title 41 / Chapter 33 / Section 41-3311
41-3311 HEARINGS.
Status: in_force

41-3311. Hearings. In all proceedings and judicial reviews thereof under sections 41-3309 and 41-3310, Idaho Code, all records of the insurer, other documents, and all insurance department files and court records and papers, so far as they pertain to or are a part of the record of the proceedings, shall be subject to disclosure according to chapter 1, title 74, Idaho Code.

History:

[41-3311, added 1981, ch. 249, sec. 2, p. 511; am. 1990, ch. 213, sec. 58, p. 526; am. 2015, ch. 141, sec. 112, p. 462.]
Idaho Code § 41-1325 — Idaho Code / Title 41 / Chapter 13 / Section 41-1325
41-1325 BORROWING MONEY FROM CLIENTS.
Status: in_force

41-1325. Borrowing money from clients. (1) An insurance producer who borrows money, securities or anything of value from a client or customer, unless the client or customer is a person engaged in the business of loaning funds or is an immediate family member of the insurance producer, shall complete a written loan agreement that sets forth the parties to the loan, the purpose of the loan, the amount of the loan and the terms of the loan. All parties to the loan must sign the loan agreement acknowledging the transaction and must receive a copy of the loan agreement. The insurance producer shall keep a record of the loan transaction until the loan is paid back in full. Any release of the debt shall be in writing and signed by all parties to the release.

(2) As used in this section, the term "immediate family member" means a parent, mother-in-law, father-in-law, husband, wife, sister, brother, brother-in-law, sister-in-law, son-in-law, daughter-in-law, or a son or daughter.

History:

[41-1325, added 2005, ch. 73, sec. 1, p. 250.]
Idaho Code § 41-610 — Idaho Code / Title 41 / Chapter 6 / Section 41-610
41-610 INCREASE OF INADEQUATE LOSS RESERVES.
Status: in_force

41-610. Increase of inadequate loss reserves. If loss experience shows that an insurer's loss reserves, however computed or estimated, are inadequate, the director shall require the insurer to maintain loss reserves in such additional amount as is needed to make them adequate. This section does not apply as to life insurance.

History:

[41-610, added 1961, ch. 330, sec. 131, p. 645.]
Idaho Code § 41-4928 — Idaho Code / Title 41 / Chapter 49 / Section 41-4928
41-4928 RECORDS AND ACCOUNTS — ANNUAL STATEMENT.
Status: in_force

41-4928. Records and accounts — Annual statement. (1) The administrator shall cause full and accurate records and accounts to be entered and maintained covering all financial transactions and affairs of the trust fund.

(2) Within sixty (60) days after the close of each calendar year, the administrator shall make an annual statement in writing summarizing the financial transactions of the trust fund for such prior calendar year and its financial condition at the end of such year in accordance with this chapter and generally accepted and applicable accounting principles. The statement shall otherwise be in the form prescribed and shall provide the information required by the director of the department of insurance of the state of Idaho, and the financial information contained therein shall be certified by the accountant by whom such information was prepared and audited.

(3) On or before the expiration of such sixty (60) day period the administrator shall cause an original of the annual statement to be filed with the director, and shall pay any filing fee required by the director or any other state agency having jurisdiction. At an appropriate time, consistent with the usual practices of the director, the director shall declare the annual statement to be open to the scrutiny of all interested parties and the public in general.

History:

[(41-4928) 41-4931, added 1990, ch. 119, sec. 1, p. 283; am. & redesig. 2003, ch. 96, sec. 32, p. 302.]
Idaho Code § 41-3103 — Idaho Code / Title 41 / Chapter 31 / Section 41-3103
41-3103 FILING OF ARTICLES — COMMENCEMENT OF BUSINESS.
Status: in_force

41-3103. Filing of articles — Commencement of business. (1) The articles of incorporation of a proposed new county mutual fire insurer, after due execution and acknowledgment as provided in section 41-3102, shall be filed as required by those provisions of section 41-2805 (filing of articles) applying to mutual insurers.

(2) After the articles of incorporation have been so filed, the directors shall adopt by-laws, elect officers, and apply to the director for a certificate of authority as a county mutual fire insurer. Upon issuance of the certificate of authority the insurer may commence business as a county mutual fire insurer.

History:

[41-3103, added 1961, ch. 330, sec. 661, p. 645.]
Idaho Code § 41-238 — Idaho Code / Title 41 / Chapter 2 / Section 41-238
41-238 NONATTENDANCE.
Status: in_force

41-238. Nonattendance. The validity of any hearing held in accordance with the notice thereof shall not be affected by failure of any person to attend or to remain in attendance.

History:

[41-238, added 1961, ch. 330, sec. 55, p. 645.]
Idaho Code § 41-1017 — Idaho Code / Title 41 / Chapter 10 / Section 41-1017
41-1017 COMMISSIONS.
Status: in_force

41-1017. Commissions. (1) An insurance company or insurance producer shall not pay a commission, service fee or other valuable consideration to a person for selling, soliciting or negotiating insurance in this state if that person is not duly licensed as required under this chapter.

(2) A person shall not accept a commission, service fee or other valuable consideration for selling, soliciting or negotiating insurance in this state if that person is not duly licensed as required under this chapter.

(3) Renewals or other deferred commissions may be paid to a person for selling, soliciting or negotiating insurance in this state if that person was duly licensed as required under this chapter at the time of the sale, solicitation or negotiation.

(4) An insurer or insurance producer may pay or assign commissions, service fees or other valuable consideration to any person, regardless of whether that person is licensed as a producer, unless the payment or assignment would violate a specific section of title 41, Idaho Code, including, but not limited to, sections 41-1314 and 41-2708, Idaho Code, or department rule.

History:

[41-1017, added 2001, ch. 296, sec. 3, p. 1057.]
Idaho Code § 41-223 — Idaho Code / Title 41 / Chapter 2 / Section 41-223
41-223 CONDUCT OF EXAMINATION — ACCESS TO RECORDS — CORRECTION OF ACCOUNTS — REMOVAL OF RECORDS.
Status: in_force

41-223. Conduct of examination — Access to records — Correction of accounts — Removal of records. (1) Upon determining that an examination should be conducted, the director or the director's designee shall issue an examination warrant appointing one (1) or more examiners to perform the examination and instructing them as to the scope of the examination. In conducting the examination, the examiner shall observe those guidelines and procedures set forth in the examiners' handbook adopted by the national association of insurance commissioners. The director may also employ such other guidelines or procedures as the director may deem appropriate.

(2) Upon such examination the director or examiner may examine under oath any officer, agent, or other individual deemed to have material information regarding the affairs of the person under examination.

(3) Every person being examined, its officers, attorneys, employees, agents, representatives or others having custody or control thereof, shall make freely available to the director or his examiners the accounts, records, documents, files, information, assets and matters in his possession or control relating to the subject of the examination, and shall facilitate the examination.

(4) If the director finds any accounts or records to be inadequate or incorrectly kept or posted, he may procure the services of competent persons to reconstruct, rewrite, post or balance them at the expense of the person being examined if such person has failed to maintain, complete or correct such records or accounts after the director has given him notice and a reasonable opportunity to do so.

(5) Neither the director nor any examiner shall remove any record, account, document, file or other property of the person being examined from the offices of such person except with the written consent of such person being given in advance of such removal, or pursuant to an order of court duly obtained. This provision shall not be deemed to affect the making and removal of copies or abstracts of any such record, account, document, or file.

(6) Nothing contained in this chapter shall be construed to limit the director's authority to terminate or suspend any examination in order to pursue other legal or regulatory action pursuant to the insurance laws of this state.

(7) Nothing contained in this chapter shall be construed to limit the director's authority to use any final examination report, or to use any examiner or company work papers or other documents, or any other information discovered or developed during the course of any examination in any judicial proceeding or administrative proceeding under this chapter.

History:

[41-223, added 1961, ch. 330, sec. 40, p. 645; am. 1993, ch. 194, sec. 2, p. 495; am. 1995, ch. 136, sec. 1, p. 587.]
Idaho Code § 41-5803 — Idaho Code / Title 41 / Chapter 58 / Section 41-5803
41-5803 LICENSE REQUIRED.
Status: in_force

41-5803. License required. (1) A person shall not act or hold himself out as a public adjuster in this state unless the person is licensed as a public adjuster in accordance with this chapter.

(2) A person licensed as a public adjuster shall not misrepresent to a claimant that he or she is an adjuster representing an insurer in any capacity, including acting as an employee of the insurer or acting as an independent adjuster unless so appointed by an insurer in writing to act on the insurer's behalf for that specific claim or purpose. A licensed public adjuster is prohibited from charging that specific claimant a fee when appointed by the insurer and the appointment is accepted by the public adjuster.

History:

[41-5803, added 2008, ch. 179, sec. 1, p. 533.]
Idaho Code § 41-1626 — Idaho Code / Title 41 / Chapter 16 / Section 41-1626
41-1626 COMPENSATION REIMBURSEMENT OPTION.
Status: in_force

41-1626. Compensation reimbursement option. Notwithstanding any other provision of this code, an insurer issuing a worker's compensation insurance contract may include as part of the contract an option allowing a policyholder at the policyholder's sole discretion, to reimburse the insurer for compensation in amounts not to exceed one thousand dollars ($1,000) per claim, subject to the following conditions:

(1) Claimant's rights shall be properly protected, and claimant's benefits have been paid by the insurer.

(2) The insurer shall pay all benefits of a compensable claim to the person or provider entitled to benefits regardless of the policyholder's option to reimburse the insurer for the claim. Payment of benefits shall not be delayed due to the decision of a policyholder to reimburse the insurer for the claim.

(3) The making of such reimbursement does not constitute a waiver or transfer of the insurer's duty to determine entitlement to benefits.

(4) In the event the insurer recovers any medical costs on a claim reimbursed pursuant to this section, the insurer shall repay the policyholder within thirty (30) days an amount equal to recovered medical costs.

(5) The claim to which a reimbursement by the policyholder applies may not exceed one thousand dollars ($1,000) over the life of the claim. Should a claim exceed the one thousand dollar ($1,000) limit after a portion has been reimbursed by the policyholder, the insurer shall within thirty (30) days notify the policyholder and return the reimbursement and adjust all reports accordingly.

(6) The policyholder shall make all reports of accidents, injuries and losses to the insurer as required under the provisions of title 72, Idaho Code, regardless of the policyholder's intent to reimburse the insurer.

(7) The insurer shall record and report all losses for the purpose of setting industry rates.

(8) Claims reimbursed pursuant to this section shall not be reported to a rating organization for the purpose of determining the policyholder's experience rating, nor shall the insurer otherwise increase a policyholder's experience rating or otherwise make charges against the policyholder for any compensation reimbursed by the policyholder pursuant to this section.

(9) No reduction in current premium may be granted as a result of a reimbursed claim.

(10) Nothing in this section shall apply to worker's compensation insurance contracts offering the policyholder a deductible pursuant to the provisions of title 72, Idaho Code.

(11) If the insurer offers the reimbursement option and the policyholder elects to exercise such option, the procedure for reimbursement shall be as follows:

(a) Within thirty (30) days following each three (3) month period after policy inception or a period mutually agreed upon by the policyholder and the insurer, the insurer shall provide the policyholder with a list of all accepted nondisabling claims for which payments were made during that period and the respective cost of each claim.

(b) No later than thirty (30) days after receipt of the list, the policyholder shall identify the claims and the dollar amount the policyholder elects to reimburse for that period, and the policyholder shall reimburse the insurer accordingly.

(c) Failure by the policyholder to reimburse the insurer within the thirty (30) days allowed shall be deemed notice to the insurer that the policyholder has not elected to make any reimbursement for that period.

History:

[41-1626, added 1999, ch. 278, sec. 1, p. 692.]
Idaho Code § 41-3413 — Idaho Code / Title 41 / Chapter 34 / Section 41-3413
41-3413 SERVICES AND BENEFITS WHICH MAY BE PROVIDED PROFESSIONAL SERVICE CORPORATIONS.
Status: in_force

41-3413. Services and benefits which may be provided professional service corporations. (1) A professional service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only:

(a) Professional services furnished to the subscriber by one (1) or more specified categories of participant licensees, as such categories are referred to in section 41-3403(9), Idaho Code, and subject to the requirements of section 41-3408(3), Idaho Code, (qualifications for authority) as to each such category;

(b) Indemnity in reasonable amounts with respect to professional services and drugs (under subscribers' contracts providing for services of participant licensee pharmacists) furnished to the subscriber by nonparticipant licensees of the same category or categories as participant licensees of the service corporation, but subject to section 41-3408(3), Idaho Code, (qualifications for authority);

(c) Indemnity in reasonable amounts with respect to hospital services furnished the subscriber while under the care and treatment of a licensee entitled to practice in such hospital;

(d) Indemnity in reasonable amounts with respect to appliances, prosthetics and similar devices and replacements, and ambulance, x-ray, physiotherapy, and similar services; and

(e) Indemnity in reasonable amounts with respect to services rendered to the subscriber by licensees of a category or categories specified in the subscriber's contract including any category of licensee defined in section 41-3403(9), Idaho Code, or rendered by other persons specified in the subscriber's contract, duly licensed by the state to engage in any health care profession or practice. The portion of the total charges to subscribers for such coverage as is authorized by this paragraph shall not exceed one-third (1/3) of the total charges to all subscribers made by the service corporation for all services and benefits rendered in any calendar year.

(2) This section shall not be deemed to prohibit such a corporation from acting as compensated servicing agent as to health care services to be provided by any public agency or under agreements between other parties not solicited by such corporation.

History:

[41-3413, added 1961, ch. 330, sec. 771, p. 645; am. 1971, ch. 252, sec. 8, p. 1008; am. 2021, ch. 321, sec. 31, p. 971.]
Idaho Code § 41-4907 — Idaho Code / Title 41 / Chapter 49 / Section 41-4907
41-4907 OWNER OR OPERATOR FINANCIAL RESPONSIBILITY.
Status: in_force

41-4907. Owner or operator financial responsibility. (1) The owner or operator shall reimburse the trust fund for all dollars expended, excluding legal defense costs, up to but not exceeding the following amounts:

(a) With respect to a heating tank – one hundred dollars ($100) per annum;

(b) With respect to a farm tank or residential tank – two thousand dollars ($2,000) per annum;

(c) With respect to an above ground storage tank or underground storage tank, as defined in section 41-4903, Idaho Code – ten thousand dollars ($10,000) per annum.

(2) Payments by the trust fund shall not be made contingent on prior payment of the reimbursement herein required.

History:

[(41-4907) 41-4906, added 1990, ch. 119, sec. 1, p. 274; am. & redesig. 2003, ch. 96, sec. 6, p. 291.]
Idaho Code § 41-4704 — Idaho Code / Title 41 / Chapter 47 / Section 41-4704
41-4704 APPLICABILITY AND SCOPE.
Status: in_force

41-4704. Applicability and scope. With the exception of a health benefit plan subject to regulation under chapter 52, title 41, Idaho Code, and to the extent permitted by federal law, the provisions of this chapter shall apply to any health benefit plan delivered or issued for delivery in the state of Idaho that provides coverage to the employees of a small employer in this state if any of the following conditions are met:

(1) Any portion of the premium or benefits is paid by or on behalf of the small employer;

(2) An eligible employee or dependent is reimbursed, whether through wage adjustments or otherwise, by or on behalf of the small employer for any portion of the premium;

(3) The health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 162, section 125 or section 106 of the United States internal revenue code.

(4) (a) Except as provided in subsection (b) of this section, for the purposes of this chapter, carriers that are affiliated companies or that are eligible to file a consolidated tax return shall be treated as one (1) carrier and any restrictions or limitations imposed in this chapter shall apply as if all health benefit plans delivered or issued for delivery to small employers in this state by such affiliated carriers were issued by one (1) carrier.

(b) An affiliated carrier that is a health maintenance organization having a certificate of authority pursuant to the provisions of chapter 39, title 41, Idaho Code, may be considered to be a separate carrier for the purposes of this chapter.

(c) Unless otherwise authorized by the director, a small employer carrier shall not enter into one (1) or more ceding arrangements with respect to health benefit plans delivered or issued for delivery to small employers in this state if such arrangements would result in less than fifty percent (50%) of the insurance obligation or risk for such health benefit plans being retained by the ceding carrier. The provisions of sections 41-510 and 41-511, Idaho Code, shall apply if a small employer carrier cedes or assumes all of the insurance obligation or risk with respect to one (1) or more health benefit plans delivered or issued for delivery to small employers in this state.

History:

[41-4704, added 1993, ch. 176, sec. 1, p. 438; am. 1994, ch. 427, sec. 3, p. 1352; am. 1995, ch. 360, sec. 3, p. 1240.]
Idaho Code § 41-616 — Idaho Code / Title 41 / Chapter 6 / Section 41-616
41-616 VALUATION OF PURCHASE MONEY MORTGAGES.
Status: in_force

41-616. Valuation of purchase money mortgages. Purchase money mortgages on real property referred to in subsection (1) of section 41-615 of this chapter shall be valued in an amount not exceeding the acquisition cost of the real property covered thereby or ninety per cent (90%) of the fair value of such real property, whichever is less.

History:

[41-616, added 1961, ch. 330, sec. 137, p. 645.]
Idaho Code § 41-4304 — Idaho Code / Title 41 / Chapter 43 / Section 41-4304
41-4304 CONSTRUCTION.
Status: in_force

41-4304. construction. The provisions of this chapter shall be construed to effect the purpose under section 41-4302, Idaho Code.

History:

[41-4304, added 2011, ch. 196, sec. 2, p. 563.]
Idaho Code § 41-4937 — Idaho Code / Title 41 / Chapter 49 / Section 41-4937
41-4937 IMPAIRED TRUST FUND.
Status: in_force

41-4937. Impaired trust fund. (1) If the assets of the trust fund are at any time insufficient to discharge its liabilities, and to maintain the required surplus, the administrator shall forthwith request authority from the director to make up the deficiency by borrowed surplus or other subordinated indebtedness.

(2) If the director finds that future estimated revenues from the transfer fees imposed under section 41-4909, Idaho Code, are not sufficient to justify any borrowed surplus funds or other subordinated indebtedness, then the director shall request the administrator to submit a plan of action whereby priority is given to the payment of cleanup costs of petroleum discharges that constitute a clear and present danger to persons or property, including discharges into underground or surface water that may seriously contaminate the water used for domestic and commercial use, agricultural products, livestock, fish, game and other wildlife. Consideration shall be given in this plan of action to establishing a claim payment priority based on the severity of the contamination, the possible endangerment of life and health including, but not limited to, possible toxic fumes, fire and explosion hazards, economic impact, population density, and the need for immediate cleanup action versus action that can be delayed with only minimal adverse effects. This plan of action shall also establish similar criteria for the prioritization of the payment of bodily injury and property damage claims.

(3) Upon receiving this plan of action, the director shall promptly hold a public hearing with appropriate notice to determine any possible adverse effects of the plan of action on the owners or operators of insured tanks, the claimants and potential claimants, and the environment. After giving due consideration to the testimony of those parties affected by the proposed plan of action, the director shall either approve or disapprove the plan in writing, stating the reasons therefor, so that a plan of action that does meet with the director's approval can be placed into effect with due diligence and dispatch.

(4) Upon receiving the director's approval of the plan of action, the administrator shall promptly commence the prioritization of claims and pay such valid and compensable claims according to this priority as funds become available from collection of the transfer fees.

History:

[(41-4937) 41-4940, added 1990, ch. 119, sec. 1, p. 286; am. 1991, ch. 59, sec. 26, p. 134; am. & redesig. 2003, ch. 96, sec. 41, p. 305.]
Idaho Code § 41-313A — Idaho Code / Title 41 / Chapter 3 / Section 41-313A
41-313A DOMESTIC RECIPROCAL INSURERS WITH FEWER THAN SEVEN SUBSCRIBERS.
Status: in_force

41-313A. Domestic reciprocal insurers with fewer than seven subscribers. Domestic reciprocal insurers with fewer than seven (7) subscribers which insure only worker's compensation risks and which only issue fully assessable policies are required, in lieu of the paid-up capital stock or basic surplus and additional surplus requirements of section 41-313, Idaho Code, to meet the security for payment of compensation standards set forth in section 72-301, Idaho Code; provided however, the securities required pursuant to this section shall be deposited with the director of the department of insurance as opposed to the industrial commission; provided further, all other rules, regulations or statutory requirements applicable to domestic reciprocal insurers administered by the director of the department of insurance remain applicable to reciprocal insurers meeting the requirements of this section.

History:

[41-313A, added 1993, ch. 279, sec. 5, p. 948.]
Idaho Code § 41-4408 — Idaho Code / Title 41 / Chapter 44 / Section 41-4408
41-4408 FILING REQUIREMENTS FOR ADVERTISING.
Status: in_force

41-4408. Filing requirements for advertising. Every issuer of medicare supplement insurance policies or certificates in this state shall provide a copy of any medicare supplement advertisement intended for use in this state whether through written, radio or television medium to the director of the Idaho department of insurance for review or approval by the director to the extent it may be required under state law.

History:

[41-4408, added 1999, ch. 102, sec. 2, p. 326.]
Idaho Code § 41-4008 — Idaho Code / Title 41 / Chapter 40 / Section 41-4008
41-4008 TRUST FUND LIABILITY — FIDUCIARY FUNDS.
Status: in_force

41-4008. Trust fund liability — fiduciary funds. (1) The trust fund of a self-funded plan shall be legally liable for payment of all applicable benefits stated in the schedule of benefits for such plan in effect at the time a claim thereunder arises.

(2) Funds in the trust fund are fiduciary funds, and are not liable to any obligation of any plan sponsor, including any employer participant or postsecondary educational institution, nor are fiduciary funds held in the trust subject to garnishment or levy. The prohibition on garnishment or levy shall not be deemed to prohibit levy upon the trust fund by any provider thereof (or its assignee) for health care services rendered to a beneficiary.

(3) All funds and moneys received by the self-funded plan and all funds billed and paid as contributions to the trust fund shall be timely deposited in the trust account and shall be held in no other name than the name of the self-funded plan.

History:

[41-4008, added 1974, ch. 248, sec. 8, p. 1624; am. 2013, ch. 181, sec. 8, p. 426.]
Idaho Code § 41-1702 — Idaho Code / Title 41 / Chapter 17 / Section 41-1702
41-1702 DEFINITIONS.
Status: in_force

41-1702. Definitions. As used in this chapter:

(1) "Accredited state" means a state in which the insurance department or regulatory agency has qualified as meeting the minimum financial regulatory standards promulgated and established from time to time by the national association of insurance commissioners (NAIC).

(2) "Broker" means an insurance broker or brokers or any other person, firm, association or corporation, when, for any compensation, commission or other thing of value, such person, firm, association or corporation acts or aids in any manner in soliciting, negotiating or procuring the making of any insurance contract on behalf of an insured other than the person, firm, association or corporation.

(3) "Control" or "controlled" has the meaning ascribed in section 41-3802(2), Idaho Code.

(4) "Controlled insurer" means a licensed insurer which is controlled, directly or indirectly, by a broker.

(5) "Controlling broker" means a broker who, directly or indirectly, controls an insurer.

(6) "Licensed insurer" or "insurer" means any person, firm, association or corporation duly licensed to transact a property/casualty insurance business in this state. The following inter alia are not licensed insurers for the purposes of this chapter:

(a) All risk retention groups as defined in the superfund amendments reauthorization act of 1986, P.L. 99-499, 100 Stat. 1613 (1986) and the risk retention act 15 U.S.C. section 3901 et seq. (1982 and supp. 1986) and chapter 48, title 41, Idaho Code;

(b) All residual market pools and joint underwriting authorities or associations; and

(c) All captive insurers. For purposes of this chapter, captive insurers are insurance companies owned by another organization whose exclusive purpose is to insure risks of the parent organization and affiliated companies or, in the case of groups and associations, insurance organizations owned by the insureds whose exclusive purpose is to insure risks to member organizations and/or group members and their affiliates.

History:

[41-1702, added 1993, ch. 194, sec. 12, p. 502; am. 2013, ch. 266, sec. 9, p. 683.]
Idaho Code § 41-3341 — Idaho Code / Title 41 / Chapter 33 / Section 41-3341
41-3341 SECURED CREDITOR'S CLAIMS.
Status: in_force

41-3341. Secured creditor's claims. (1) The value of any security held by a secured creditor shall be determined in one (1) of the following ways, as the court may direct:

(a) By converting the same into money according to the terms of the agreement pursuant to which the security was delivered to such creditors; or

(b) By agreement, arbitration, compromise or litigation between the creditor and the liquidator.

(2) The determination shall be under the supervision and control of the court with due regard for the recommendation of the liquidator. The amount so determined shall be credited upon the secured claim, and any deficiency shall be treated as an unsecured claim. If the claimant shall surrender his security to the liquidator, the entire claim shall be allowed as if unsecured.

History:

[41-3341, added 1981, ch. 249, sec. 2, p. 532.]
Idaho Code § 41-3109 — Idaho Code / Title 41 / Chapter 31 / Section 41-3109
41-3109 DIRECTORS.
Status: in_force

41-3109. Directors. (1) The affairs of the insurer shall be under the direction of a board of directors comprised of not less than nine (9) nor more than twenty-five (25) members of the insurer.

(2) After expiration of the term of initial directors, if any, as provided for in the articles of incorporation, directors shall be elected at the annual meeting of the insurer's members for terms of not more than three (3) years each. If terms of more than one (1) year are used, the terms of directors shall be staggered so that the terms of a proportionate number of directors will expire each year.

(3) A director may also act as an agent for the insurer with the same but not greater contract authority as any other agent.

History:

[41-3109, added 1961, ch. 330, sec. 667, p. 645; am. 1983, ch. 46, sec. 1, p. 117.]
Idaho Code § 41-1003 — Idaho Code / Title 41 / Chapter 10 / Section 41-1003
41-1003 DEFINITIONS.
Status: in_force

41-1003. Definitions. (1) "Business entity" means a corporation, association, partnership, limited liability company, limited liability partnership or other legal entity.

(2) "Home state" means the District of Columbia and any state or territory of the United States or any province of Canada in which an insurance producer maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance producer.

(3) "License" means a document issued by the director authorizing a person to act as an insurance producer for the lines of authority specified in the document. The license itself does not create any authority, actual, apparent or inherent, in the holder to represent or commit an insurance carrier.

(4) "Limited lines insurance" is insurance which restricts the authority of the license to less than the total authority prescribed in the associated major lines pursuant to section 41-1008(1)(a) through (g), Idaho Code, and shall include, but not be limited to: credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection (GAP) insurance, transportation baggage insurance, transportation ticket policies covering personal accident insurance, pet insurance, portable electronics insurance, travel insurance or any other line of insurance that the director deems necessary to recognize for the purposes of complying with section 41-1009(5), Idaho Code.

(5) "Limited lines producer" means a producer authorized by the director to sell, solicit or negotiate limited lines insurance. "Limited lines producer" includes a "limited lines travel insurance producer" as used in sections 41-1090 through 41-1096, Idaho Code.

(6) "Negotiate" means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms or conditions of the contract, provided that the person engaged in the act either sells insurance or obtains insurance from insurers for purchasers.

(7) "Person" means an individual or a business entity.

(8) "Producer" means a person required to be licensed under the laws of this state to sell, solicit or negotiate insurance.

(9) "Resident" means a person whose home state is Idaho or any other particular state identified in conjunction with the use of the term.

(10) "Sell" means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company.

(11) "Solicit" means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company or companies.

(12) "Terminate" means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance for or on behalf of an insurer.

(13) "Uniform application" means the current version of the national association of insurance commissioners (NAIC) uniform application for resident and nonresident producer licensing.

(14) "Uniform business entity application" means the current version of the NAIC uniform business entity application for resident and nonresident business entities.

History:

[41-1003, added 2001, ch. 296, sec. 3, p. 1047; am. 2012, ch. 226, sec. 1, p. 619; am. 2017, ch. 198, sec. 1, p. 494.]
Idaho Code § 41-211 — Idaho Code / Title 41 / Chapter 2 / Section 41-211
41-211 RULES.
Status: in_force

41-211. Rules. (1) The director may make reasonable rules necessary for or as an aid to the effectuation of any provision of this code. No such rule shall extend, modify, or conflict with any law of this state or the reasonable implications thereof.

(2) Any such rule affecting persons or matters other than the personnel or the internal affairs of the department shall be made or amended in accordance with the provisions of chapter 52, title 67, Idaho Code.

(3) In addition to any other penalty provided, wilful violation of any such rule shall subject the violator to such suspension or revocation of certificate of authority or license as may be applicable under this code as for violation of the provision as to which such rule relates.

History:

[41-211, added 1961, ch. 330, sec. 28, p. 645; am. 1994, ch. 310, sec. 1, p. 977.]
Idaho Code § 41-1018 — Idaho Code / Title 41 / Chapter 10 / Section 41-1018
41-1018 APPOINTMENTS.
Status: in_force

41-1018. Appointments. (1) An insurance producer shall not act as an agent of an insurer unless the insurance producer becomes an appointed agent of that insurer. An insurance producer who is not acting as an agent of an insurer is not required to become appointed.

(2) To appoint a producer as its agent, the appointing insurer shall file, in a format approved by the director, a notice of appointment within fifteen (15) days from the date the agency contract is executed or the first insurance application is submitted.

(3) Upon receipt of the notice of appointment, the director shall verify, within a reasonable time not to exceed thirty (30) days, that the insurance producer is eligible for appointment. If the insurance producer is determined to be ineligible for appointment, the director shall notify the insurer within five (5) days of his determination.

History:

[41-1018, added 2001, ch. 296, sec. 3, p. 1058.]
Idaho Code § 41-1335 — Idaho Code / Title 41 / Chapter 13 / Section 41-1335
41-1335 RELEASE OF PATIENT IDENTIFIABLE PRESCRIPTION INFORMATION PROHIBITED — EXCEPTIONS.
Status: in_force

41-1335. Release of patient identifiable prescription information prohibited — Exceptions. (1) No person shall release or sell, or include in any policy of insurance delivered or issued for delivery in this state any provision for the release or sale of any information pertaining to prescriptions, drug orders, records or any other prescription information that specifically identifies an individual insured, except as authorized under the provisions of section 54-1727, Idaho Code.

(2) In addition to any other penalties provided by law, any person violating the provisions of this section shall be subject to an administrative penalty not to exceed three thousand dollars ($3,000) for each violation.

(3) No person who releases records or information specified in subsection (1) of this section in good faith pursuant to the provisions of section 54-1727, Idaho Code, shall be subject to penalty or liability, nor shall a cause of action exist against such person, for any loss or damage based upon the release of the records or information.

History:

[41-1335, added 2000, ch. 189, sec. 2, p. 467.]
Idaho Code § 41-1622 — Idaho Code / Title 41 / Chapter 16 / Section 41-1622
41-1622 INFORMATION TO INSUREDS — REVIEW OF INSURED'S COMPLAINT.
Status: in_force

41-1622. Information to insureds — Review of insured's complaint. (1) Every rating organization and every insurer which makes its own rates shall, within a reasonable time after receiving written request therefor and upon payment of such reasonable charges as it may make, furnish to any insured affected by a rate made by it, or to the authorized representative of such insured, all pertinent information as to such rate.

(2) Every rating organization and every insurer which makes its own rates shall provide within this state reasonable means whereby any person aggrieved by the application of its rating system may be heard, in person or by his authorized representative, on his written request to review the manner in which such rating system has been applied in connection with the insurance afforded him. If the rating organization or insurer fails to grant or reject such request within thirty (30) days after it is made, the applicant may proceed in the same manner as if his application had been rejected. Any party affected by the action of such rating organization or such insurer on such request may, within thirty (30) days after written notice of such action, appeal to the director, who, after a hearing held upon notice to the appellant and to such rating organization or insurer in accordance with chapter 2, title 41, Idaho Code, may affirm or reverse such action.

History:

[41-1622, added 1969, ch. 306, sec. 22, p. 917; am. 2005, ch. 77, sec. 21, p. 268.]
Idaho Code § 41-343 — Idaho Code / Title 41 / Chapter 3 / Section 41-343
41-343 ARTICLES OF REDOMESTICATION.
Status: in_force

41-343. Articles of redomestication. (1) Upon receiving approval under section 41-342, Idaho Code, articles of redomestication shall be executed in duplicate by an insurance corporation by its president or a vice president and by its secretary or an assistant secretary and verified by one (1) of the officers of the corporation and shall set forth:

(a) The date of approval of the director of the Idaho department of insurance of the redomestication; and

(b) The state in which the insurer was originally incorporated, the date the insurer was incorporated in that state, and the date the insurer was authorized to do business as an insurer in the state in which it was originally incorporated.

(2) The insurer shall attach to the articles of redomestication:

(a) Articles of incorporation including such amendments as may be required to comply with the requirements of part 10, chapter 29, title 30, Idaho Code;

(b) A copy of the certificate of redomestication issued by the director of the Idaho department of insurance.

(3) Duplicate originals of the articles of redomestication shall be delivered to the secretary of state. If the secretary of state finds that such articles conform to law, he shall, when all fees have been paid as prescribed in chapter 21, title 30, Idaho Code:

(a) Endorse on each of such duplicate originals the word "Filed," and the month, day and year of the filing, together with the date from which the insurer has existed and operated as an insurer which shall be the date the insurer was originally incorporated in the state in which the insurer was originally incorporated;

(b) File one (1) of such duplicate originals in his office; and

(c) Issue a certificate of redomestication setting forth the date on which the articles of redomestication were filed and the date from which the insurer has existed and operated as an insurer which shall be the date the insurer was originally incorporated in the state in which the insurer was originally incorporated.

(4) The certificate of redomestication, together with the duplicate original of the articles of redomestication affixed thereto by the secretary of state, shall be returned to the insurer or to its representative.

History:

[41-343, added 1987, ch. 302, sec. 2, p. 642; am. 2017, ch. 58, sec. 23, p. 117.]
Idaho Code § 41-1096 — Idaho Code / Title 41 / Chapter 10 / Section 41-1096
41-1096 NO NEGATIVE OPTION OR OPT OUT.
Status: in_force

41-1096. no negative option or opt out. No person offering travel insurance on an individual or group basis may do so using a negative option or option to opt out, that would require a consumer to take an affirmative action to deselect coverage such as unchecking a box on an electronic form when purchasing a trip. It shall not be an unfair trade practice to include blanket travel insurance coverage with the purchase of a trip, provided the coverage is not marketed as free.

History:

[41-1096, added 2017, ch. 198, sec. 8, p. 497.]