Okla. Stat. tit. 36, § 36-1538 — OK Code / Title 36 / Section 36-1538
Confidentiality and privilege
Status: in_force

A. Documents, materials or other information including the

Corporate Governance Annual Disclosure (CGAD), in the possession or

control of the Oklahoma Insurance Department that is obtained by,

created by or disclosed to the Insurance Commissioner or any other

person under this act, is recognized by this state as being

proprietary and to contain trade secrets. All such documents,

materials or other information shall be confidential by law and

privileged, shall not be subject to the Oklahoma Open Records Act,

subpoena, and discovery or admissible in evidence in any private

civil action. However, the Commissioner is authorized to use the

documents, materials or other information in the furtherance of any

regulatory or legal action brought as a part of the Commissioner's

official duties. The Commissioner shall not otherwise make the

documents, materials or other information public without the prior

written consent of the insurer. Nothing in this section shall be

construed to require written consent of the insurer before the

Commissioner may share or receive confidential documents, materials

or other CGAD-related information pursuant to subsection C of this

section to assist in the performance of the Commissioner's regular

duties.

Oklahoma Statutes - Title 36. Insurance Page 426

B. Neither the Commissioner nor any person who received

documents, materials or other CGAD-related information, through

examination or otherwise, while acting under the authority of the

Commissioner, or with whom such documents, materials or other

information is shared pursuant to this act shall be permitted or

required to testify in any private civil action concerning any

confidential documents, materials, or information subject to

subsection A of this section.

C. In order to assist in the performance of the Commissioner's

regulatory duties, the Commissioner:

1. May, upon request, share documents, materials or other CGAD-

related information including the confidential and privileged

documents, materials or information subject to subsection A of this

section, including proprietary and trade secret documents and

materials, with other state, federal and international financial

regulatory agencies, including members from the National Association

of Insurance Commissioners (NAIC), and with third-party consultants

pursuant to Section 6 of this act, provided that the recipient

agrees in writing to maintain the confidentiality and privileged

status of the CGAD-related documents, material or other information

and has verified in writing the legal authority to maintain

confidentiality; and

2. May receive documents, materials or other CGAD-related

information, including otherwise confidential and privileged

documents, materials or information, including proprietary and trade

secret information or documents, from regulatory officials of other

state, federal and international financial regulatory agencies,

including members from the NAIC and shall maintain as confidential

or privileged any documents, materials or information received with

notice or the understanding that it is confidential or privileged

under the laws of the jurisdiction that is the source of the

documents, materials or information.

D. The sharing of information and documents by the Commissioner

pursuant to this act shall not constitute a delegation of regulatory

authority or rulemaking, and the Commissioner is solely responsible

for the administration, execution and enforcement of the provisions

of this act.

E. No waiver of any applicable privilege or claim of

confidentiality in the documents, proprietary and trade secret

materials or other CGAD-related information shall occur as a result

of disclosure of such CGAD-related information or documents to the

Commissioner under this section or as a result of sharing as

authorized in this act.
Okla. Stat. tit. 36, § 36-1910 — OK Code / Title 36 / Section 36-1910
Order of rehabilitation; termination
Status: in_force

A. An order to rehabilitate a domestic insurer shall direct the

Insurance Commissioner forthwith to take possession of the property

of the insurer and to conduct the business thereof, and to take such

steps toward removal of the causes and conditions which have made

rehabilitation necessary as the court may direct.

B. If at any time the Insurance Commissioner deems that further

efforts to rehabilitate the insurer would be useless, he may apply

to the court for an order of liquidation.

C. The Insurance Commissioner, or any interested person upon

due notice to the Insurance Commissioner, at any time may apply to

the court for an order terminating the rehabilitation proceedings

and permitting the insurer to resume possession of its property and

the conduct of its business, but no such order shall be granted

except when, after a full hearing, the court has determined that the

purposes of the proceeding have been fully accomplished.
Okla. Stat. tit. 36, § 36-6124 — OK Code / Title 36 / Section 36-6124
Application for permit - Renewal
Status: in_force

A. Applications for a permit shall be filed electronically with

the Insurance Commissioner, in the manner and form prescribed by the

Insurance Commissioner, and shall at the time of filing include a

filing fee of Fifty Dollars ($50.00) along with any transaction or

other applicable fees. The Insurance Commissioner may issue a

permit upon:

1. The receipt of the application and payment of the filing

fee;

2. Determination that the organization is in good standing with

the Oklahoma Funeral Board; and

3. Making a finding that the organization has complied with

this act and the rules promulgated under this act by the Insurance

Commissioner. All applications shall be signed by the organization

requesting the permit, and shall contain a statement that the

organization will comply with all the requirements as established by

this act. All permits shall expire annually on December 31, unless

renewed; permits may be renewed for a period not to exceed the

succeeding December 31 upon the payment of a renewal fee of Fifty

Dollars ($50.00). A permit expired for failure to submit a renewal

application may be reinstated within ninety (90) days after the

expiration date by electronically submitting a fee in an amount that

Oklahoma Statutes - Title 36. Insurance Page 1139

is double the renewal fee and a renewal application in the form and

manner prescribed by the Insurance Commissioner, along with any

transaction or other applicable fees. A permit holder whose permit

has been expired for more than ninety (90) days shall reapply as if

they were a new applicant and pay an application fee equal to an

amount that is double the renewal fee in addition to any fines

imposed. All applications received after the permit has been

expired for more than ninety (90) days shall include a detailed

report in the form and manner prescribed by the Insurance

Commissioner of any prepaid funeral benefits offered or provided in

this state during the period of the expired permit.

B. The Insurance Commissioner may suspend, revoke, or refuse to

renew a permit or refuse to issue a permit for failure to comply

with any provision of this act, or any valid rule, which the

Insurance Commissioner has promulgated, after reasonable notice and

opportunity for a hearing. When the Insurance Commissioner suspends

or revokes a permit or refuses to issue a renewal of a permit for a

violation, the Insurance Commissioner shall notify the Oklahoma

Funeral Board of the action and the nature of any violations.

C. No organization shall be entitled to a new permit for a

period of one (1) year after revocation or refusal by the Insurance

Commissioner to issue or renew the permit of the organization, but

shall thereafter be entitled to a new permit upon satisfactory proof

of compliance with this law after the expiration of the one-year

period.

D. Any organization aggrieved by the actions of the Insurance

Commissioner may appeal therefrom as provided by Article II of the

Administrative Procedures Act.
Okla. Stat. tit. 36, § 36-937 — OK Code / Title 36 / Section 36-937
Hearing on order or decision by Commission made without a
Status: in_force

hearing - Appeal to Supreme Court.

A. Any insurer or advisory organization aggrieved by any order

or decision of the Insurance Commissioner, made without a hearing,

may, within thirty (30) days after notice of the order to the

insurer or organization, make written request to the Commissioner

for a hearing thereon. The Commissioner shall hear such party or

parties within twenty (20) days after receipt of such request and

shall give not less than ten (10) days' written notice of the time

and place of the hearing. Within fifteen (15) days after such

hearing, the Commissioner shall affirm, reverse or modify the

previous action of the Commissioner, specifying its reasons

therefor. Pending such hearing and decision thereon, the

Commissioner may suspend or postpone the effective date of the

previous action of the Commissioner.

B. Nothing contained in this act shall require the observance

at any hearing, of formal rules of pleading or evidence.

C. Except as otherwise provided in this act, any order or

decision of the Commissioner made pursuant to this act shall be

subject to review by appeal to the Supreme Court of Oklahoma at the

instance of any party in interest. Such party in interest may

appeal from such order or decision by filing with the Clerk of the

Supreme Court, within thirty (30) days from the date of such order

or decision, a petition in error with a copy of the order or

decision appealed from. The time limit prescribed herein for filing

the petition in error may not be extended. The Supreme Court shall

prescribe, by rule, the manner in which the record of the

proceedings, sought to be reviewed, shall be perfected and the time

for its completion. The appeal shall not stay the execution of any

Oklahoma Statutes - Title 36. Insurance Page 210

order or decision of the Commissioner unless the Supreme Court

shall, for cause shown, order that said decision or order be stayed

pending such appeal, in which event the Court shall determine the

terms and conditions upon which the same shall be stayed; provided,

premiums collected prior to the effective date of the order of the

Court imposing a stay shall be retained by the insurer unless the

Court finds that such premiums were obtained by fraud, or unless

otherwise ordered by the Court.

The Court may, in disposing of the issue before it, determine

all issues of law and fact, and may modify, affirm or reverse the

order or decisions of the Commissioner in whole or in part.
Okla. Stat. tit. 36, § 36-309.2 — OK Code / Title 36 / Section 36-309.2
Nature and frequency of examinations - Reports in lieu
Status: in_force

of examinations.

A. The Insurance Commissioner or an examiner may conduct an

examination, including a financial and market conduct examination,

under Sections 309.1 through 309.7 of this title of any company as

often as the Commissioner deems appropriate but shall at a minimum,

conduct a financial examination of every domestic insurer licensed

in this state not less frequently than once every five (5) years.

The Commissioner shall, at a minimum, conduct or cause to be

conducted a financial examination of every foreign insurer licensed

in this state not less frequently than once every five (5) years.

The Commissioner may accept examinations conducted by other states

on foreign insurers domiciled in such states pursuant to subsection

D of this section. In scheduling and determining the nature, scope

and frequency of the examinations, the Commissioner shall consider

such matters as the results of financial statement analyses and

ratios, changes in management or ownership, actuarial opinions,

reports of independent certified financial examiners or public

accountants and other criteria as set forth in the Examiners'

Handbook adopted by the National Association of Insurance

Commissioners and in effect when the Commissioner exercises

discretion under this subsection. The Commissioner may also make

examinations upon the request of one or more persons pecuniarily

interested therein, who shall make affidavit of their belief, with

specifications of their reasons therefor, that the company is in an

unsound condition.

B. The Commissioner may adopt rules setting forth criteria and

informing domestic insurers of those factors which may contribute to

the Commissioner requiring the financial examination of an insurer

prior to the end of the five-year-examination requirement provided

in subsection A of this section.

C. For purposes of completing an examination of any company

under Sections 309.1 through 309.7 of this title, the Commissioner

may examine or investigate any person, or the business of any

person, insofar as such examination or investigation is, in the sole

discretion of the Commissioner, necessary or material to the

examination of the company.

D. In lieu of an examination under Sections 309.1 through 309.7

of this title of any foreign or alien insurer licensed in this

state, the Commissioner may accept an examination report on such

company as prepared by the insurance department for the company's

state of domicile or port-of-entry state if:

1. The insurance department was at the time of the examination

accredited under the National Association of Insurance

Oklahoma Statutes - Title 36. Insurance Page 63

Commissioners' Financial Regulation Standards and Accreditation

Program; or

2. The examination is performed with the participation of one

or more examiners who are employed by an accredited state insurance

department and who, after a review of the examination work papers

and report, state under oath that the examination was performed in a

manner consistent with the standards and procedures required by

their insurance department.

E. The Commissioner may authorize any employee of the Insurance

Department to exercise the Commissioner's authority under Sections

309.1 through 309.7 of this title.
Okla. Stat. tit. 36, § 36-6216.1 — OK Code / Title 36 / Section 36-6216.1
Payment of claim to public adjuster - Insured as joint
Status: in_force

payee.

No insurance company authorized to transact insurance in this

state shall make payment of any insurance claim, or any portion of a

claim, to a public adjuster on account of services rendered by a

public adjuster to an insured unless the name of the insured is

added as a joint payee on any claim check, draft or electronic

payment. The payment, whether by check, draft, electronic payment

or otherwise, shall be sent to the address or electronic mail

address designated by the insured.
Okla. Stat. tit. 36, § 36-6470.17 — OK Code / Title 36 / Section 36-6470.17
Membership in rating organization
Status: in_force

A captive insurance company may not be required to join a rating

organization.
Okla. Stat. tit. 36, § 36-311A.13 — OK Code / Title 36 / Section 36-311A.13
Work papers - Availability for examiner review -
Status: in_force

Copies.

A. Work papers are the records kept by the independent

certified public accountant of the procedures followed, the tests

performed, the information obtained, and the conclusions reached

pertinent to the audit by the accountant of the financial statements

of an insurer. Work papers, accordingly, may include audit planning

documentation, work programs, analyses, memoranda, letters of

confirmation and representation, abstracts of company documents, and

schedules or commentaries prepared or obtained by the independent

certified public accountant in the course of the audit of the

financial statements of an insurer and which support the opinion of

the accountant.

B. Every insurer required to file an audited financial report

pursuant to the Oklahoma Annual Financial Report Act, shall require

the accountant to make available for review by Insurance Department

examiners, all work papers prepared in the conduct of the audit by

the accountant and any communications related to the audit between

the accountant and the insurer, at the offices of the insurer, at

the offices of the Insurance Department, or at any other reasonable

place designated by the Insurance Commissioner. The insurer shall

require that the accountant retain the audit work papers and

communications until the Insurance Department has filed a report on

examination covering the period of the audit but no longer than

seven (7) years from the date of the audit report.

C. In the conduct of the aforementioned periodic review by the

Commissioner or Insurance Department examiners, it shall be agreed

that photocopies of pertinent audit work papers may be made and

retained by the Insurance Department. Such reviews by the

Commissioner or Insurance Department examiners shall be considered

investigations and all working papers, recorded information,

documents, copies thereof and communications obtained during the

course of such investigations shall be afforded the same

confidentiality as other examination work papers generated by the

Insurance Department pursuant to subsection F of Section 309.4 of

this title.
Okla. Stat. tit. 36, § 36-4511 — OK Code / Title 36 / Section 36-4511
Employer health care programs - Pharmacy services -
Status: in_force

Violation.

A. No employer providing pharmacy services including

prescription drugs to any employee or retiree of said employer, as

part of a health care program, shall knowingly require the employee

or retiree of said employer to obtain drugs from a mail order

pharmacy as a condition of obtaining the employer's payment for such

prescription drugs.

B. Any person violating the provisions of this section, upon

conviction, shall be guilty of a misdemeanor. Each such violation

shall constitute a separate offense.
Okla. Stat. tit. 36, § 36-6129 — OK Code / Title 36 / Section 36-6129
Records - Annual statement of financial condition
Status: in_force

Each organization which has outstanding contracts for prepaid

funeral benefits shall maintain within this state such records as

the Insurance Commissioner may require to enable the Insurance

Commissioner to determine whether the organization is complying with

the provisions of Sections 6121 through 6136.18 of this title. Each

organization shall provide to the Insurance Commissioner an annual

statement of the financial condition of funds collected pursuant to

contracts for prepaid funeral benefits. The statement shall be due

by the fifteenth day of March of each year and shall reflect, at a

minimum, the assets and liabilities of each prepaid funeral benefits

fund and the location and status of all trust funds for prepaid

funeral benefits as of the last day of December of the preceding

year. Failure to file an annual statement by the date required may

result in censure, or suspension or revocation of the permit, or an

administrative penalty imposed by the Insurance Commissioner not to

exceed One Thousand Dollars ($1,000.00) for each occurrence, or be

subject to both penalty and punishment.
Okla. Stat. tit. 36, § 36-6127 — OK Code / Title 36 / Section 36-6127
Merchandise price display
Status: in_force

Any organization or person offering for sale caskets or other

articles of merchandise incidental to burial or funeral services

shall prominently display thereon the retail price of said caskets,

or other articles of merchandise.
Okla. Stat. tit. 36, § 36-2005 — OK Code / Title 36 / Section 36-2005
Creation - Administration - Accounts - Membership - Plan
Status: in_force

of operation.

A. There is hereby created a nonprofit, unincorporated legal

entity to be known as the Oklahoma Property and Casualty Insurance

Guaranty Association. For purposes of administration and

assessment, the Association shall be divided into three separate

accounts:

1. The workers' compensation insurance account;

2. The automobile insurance account; and

3. The account for all other insurance to which the Oklahoma

Property and Casualty Insurance Guaranty Association Act applies.

Oklahoma Statutes - Title 36. Insurance Page 575

B. All insurers defined as member insurers pursuant to Section

2004 of this title shall be and remain members of the Association as

a condition of their authority to transact insurance in this state.

The Association shall perform its functions under a plan of

operation established and approved under the Oklahoma Property and

Casualty Insurance Guaranty Association Act.
Okla. Stat. tit. 36, § 36-4250 — OK Code / Title 36 / Section 36-4250
Rate filing – Definitions
Status: in_force

A. On or after the effective date of this act, pursuant to the

provisions of this section and any other applicable section of Title

36 of the Oklahoma Statutes, every health benefit plan shall file

all group and individual initial rates and group and individual rate

adjustments with the Insurance Commissioner. If the Commissioner

determines that the initial rate or rate adjustment is unreasonable,

excessive, unjustified or unfairly discriminatory, the Commissioner

shall make a written decision stating the reason or reasons for the

determination, and shall deliver a copy of the determination to the

company within thirty (30) calendar days unless the Commissioner

extends the determination period for an additional thirty (30)

Oklahoma Statutes - Title 36. Insurance Page 935

calendar days.

B. 1. For purposes of this section, "health benefit plan"

means a plan that:

a. provides benefits for medical or surgical expenses

incurred as a result of a health condition, accident,

or sickness, and

b. is offered by any insurance company, group hospital

service corporation, or health maintenance

organization that delivers or issues for delivery an

individual, group, blanket, or franchise insurance

policy or insurance agreement, a group hospital

service contract, or an evidence of coverage, or, to

the extent permitted by the Employee Retirement Income

Security Act of 1974, 29 U.S.C., Section 1001 et seq.,

by a multiple employer welfare arrangement as defined

in Section 3 of the Employee Retirement Income

Security Act of 1974, or any other analogous benefit

arrangement, whether the payment is fixed or by

indemnity.

2. The term "health benefit plan" shall not include:

a. a plan that provides coverage:

(1) only for a specified disease or diseases or under

an individual limited benefit policy,

(2) only for accidental death or dismemberment,

(3) for dental or vision care,

(4) a hospital confinement indemnity policy or other

fixed indemnity insurance,

(5) disability income insurance or a combination of

accident-only and disability income insurance, or

(6) as a supplement to liability insurance,

b. a Medicare supplemental policy as defined by Section

1882(g)(1) of the Social Security Act (42 U.S.C.,

Section 1395ss),

c. workers’ compensation insurance coverage,

d. medical payment insurance issued as part of a motor

vehicle insurance policy,

e. a long-term care policy, including a nursing home

fixed indemnity policy, unless a determination is made

that the policy provides benefit coverage so

comprehensive that the policy meets the definition of

a health benefit plan,

f. short-term health insurance issued on a nonrenewable

basis with duration of six (6) months or less,

g. policy issued under Title XVIII, or

h. a plan issued to any person, firm, corporation,

partnership, limited liability company or association

that is actively engaged in business and that, on at

Oklahoma Statutes - Title 36. Insurance Page 936

least fifty percent (50%) of its working days during

the preceding calendar quarter, employed more than

fifty (50) eligible employees.
Okla. Stat. tit. 36, § 36-1703 — OK Code / Title 36 / Section 36-1703
Assets eligible for deposit
Status: in_force

A. All such deposits required for authority to transact

insurance business in Oklahoma shall consist of cash, under

negotiable and transferable certificates of deposit or other time

deposit instruments issued by solvent insured banks, savings and

loan associations, and trust companies in Oklahoma, or a combination

of the foregoing and the securities described in Sections 1607,

1608, 1609 and 1620 of this title.

Oklahoma Statutes - Title 36. Insurance Page 521

B. All such deposits required pursuant to the laws of another

state, province, or country, or pursuant to the retaliatory

provision of Section 628 of this title, shall consist of such assets

as are required or permitted by such laws, or as required pursuant

to such retaliatory provision.
Okla. Stat. tit. 36, § 36-2738.1 — OK Code / Title 36 / Section 36-2738.1
Exemption of certain societies
Status: in_force

A. Nothing contained in this article shall be so construed as

to affect or apply to:

1. Grand or subordinate lodges of societies, orders or

associations now doing business in this state which provide benefits

exclusively through local or subordinate lodges;

2. Orders, societies or associations which admit to membership

only persons engaged in one or more crafts or hazardous occupations,

in the same or similar lines of business, insuring only their own

members and their families, and the ladies' societies or ladies'

auxiliaries to such orders, societies or associations;

3. Domestic societies which limit their membership to employees

of a particular city or town, designated firm, business house or

corporation which provide for a death benefit of not more than Four

Hundred Dollars ($400.00) or disability benefits of not more than

Three Hundred Fifty Dollars ($350.00) to any person in any one (1)

year, or both; or

4. Domestic societies or associations of a purely religious,

charitable or benevolent description, which provide for a death

benefit of not more than Four Hundred Dollars ($400.00) or for

Oklahoma Statutes - Title 36. Insurance Page 736

disability benefits of not more than Three Hundred Fifty Dollars

($350.00) to any one person in any one (1) year, or both.

B. Any such society or association described in paragraph 3 or

paragraph 4 of subsection A of this section which provides for death

or disability benefits for which benefit certificates are issued,

and any such society or association included in subsection D of this

section which has more than one thousand members, shall not be

exempted from the provisions of this article but shall comply with

all requirements thereof.

C. No society which, by the provisions of this section, is

exempt from the requirements of this article, except any society

described in paragraph 2 of subsection A of this section, shall give

or allow or promise to give or allow to any person any compensation

for procuring new members.

D. Every society which provides for benefits in case of death

or disability resulting solely from accident, and which does not

obligate itself to pay natural death or sick benefits shall have all

of the privileges and be subject to all the applicable provisions

and regulations of this article; provided, however, the provisions

thereof relating to medical examination, valuations of benefit

certificates, and incontestability, shall not apply to such society.

E. The Insurance Commissioner may require from any society or

association, by examination or otherwise, such information as will

enable the Commissioner to determine whether such society or

association is exempt from the provisions of this article.

F. Societies, exempted under the provisions of this section,

shall also be exempt from all other provisions of the insurance laws

of this state.
Okla. Stat. tit. 36, § 36-4415 — OK Code / Title 36 / Section 36-4415
Definitions – Standard health benefit plans for individuals under 40 years of age –
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 27individuals under 40 years of age – Coverage disclosure statements

and acknowledgments – Rate filings - Rules.

A. As used in this section:

1. “Health carrier” means any entity or insurer authorized

under Title 36 of the Oklahoma Statutes to provide accident or

health insurance or health benefits in this state and any entity or

person engaged in the business of making contracts of accident or

health insurance;

2. “Standard health benefit plan” means an accident or health

insurance policy that does not offer or provide state-mandated

health benefits but that provides creditable coverage and is issued

to an individual under forty (40) years of age; and

3. a. “State-mandated health benefits” means coverage for

health care services or benefits, required by state

law or state regulations, requiring the reimbursement

or utilization related to a specific illness, injury,

or condition of the covered person, including those

Oklahoma Statutes - Title 36. Insurance Page 961

provisions listed in Sections 6060 through 6060.11 of

Title 36 of the Oklahoma Statutes.

b. “State-mandated health benefits” does not mean those

benefits found in Sections 4401 through 4411 and 4501

through 4513 of Title 36 of the Oklahoma Statutes.

B. 1. A health carrier may offer one or more standard health

benefit plans to individuals under forty (40) years of age.

2. Each application and health benefit plan issued pursuant to

this section shall contain the following language at the beginning

of the document in bold type:

“This standard health benefit plan does not provide state-

mandated health benefits normally required in accident and health

insurance policies in the State of Oklahoma. This standard health

benefit plan may provide a more affordable health insurance policy

for you although, at the same time, it may provide you with fewer

health benefits than those normally included as state-mandated

health benefits in policies in the State of Oklahoma.”

C. An insurer providing a standard health benefit plan shall

provide a proposed policyholder or policyholder with a written

disclosure statement that:

1. Lists those state-mandated health benefits not included

under the standard health benefit plan and acknowledges that the

plan being purchased does not provide those benefits; and

2. Provides a notice that purchase of the plan may limit the

future coverage options of the policyholder in the event the health

of the policyholder changes and needed benefits are not available

under the standard health benefit plan.

D. Each applicant for initial coverage and each policyholder on

renewal of coverage shall sign the disclosure statement provided by

the insurer under subsection C of this section and return the

statement to the insurer. An insurer shall:

1. Retain the signed disclosure statement in the records of the

insurer; and

2. Upon request of the Insurance Commissioner, provide the

signed disclosure statement to the Oklahoma Insurance Department.

E. An insurer that offers one or more standard health benefit

plans as provided in this section shall also offer at least one

accident or health insurance policy with state-mandated health

benefits that is otherwise authorized by Title 36 of the Oklahoma

Statutes.

F. A health carrier shall file, for informational purposes

only, with the Oklahoma Insurance Department the rates to be used

with a standard health benefit plan.

G. The Insurance Commissioner shall adopt rules necessary to

implement the provisions of this section.
Okla. Stat. tit. 36, § 36-3636 — OK Code / Title 36 / Section 36-3636
Uninsured motorist coverage
Status: in_force

A. No policy insuring against loss resulting from liability

imposed by law for bodily injury or death suffered by any person

arising out of the ownership, maintenance or use of a motor vehicle

shall be issued, delivered, renewed, or extended in this state with

respect to a motor vehicle registered or principally garaged in this

state unless the policy includes the coverage described in

subsection B of this section.

B. The policy referred to in subsection A of this section shall

provide coverage therein or supplemental thereto for the protection

of persons insured thereunder who are legally entitled to recover

damages from owners or operators of uninsured motor vehicles and

hit-and-run motor vehicles because of bodily injury, sickness or

disease, including death resulting therefrom. Coverage shall be not

less than the amounts or limits prescribed for bodily injury or

death for a policy meeting the requirements of Section 7-204 of

Title 47 of the Oklahoma Statutes, as the same may be hereafter

amended; provided, however, that increased limits of liability shall

be offered and purchased if desired, not to exceed the limits

provided in the policy of bodily injury liability of the insured.

Policies issued, renewed or reinstated after November 1, 2014, shall

not be subject to stacking or aggregation of limits unless expressly

provided for by an insurance carrier. The uninsured motorist

coverage shall be upon a form approved by the Insurance Commissioner

as otherwise provided in the Insurance Code and may provide that the

parties to the contract shall, upon demand of either, submit their

differences to arbitration; provided, that if agreement by

arbitration is not reached within three (3) months from date of

demand, the insured may sue the tort-feasor.

C. For the purposes of this coverage the term "uninsured motor

vehicle" shall include an insured motor vehicle where the liability

Oklahoma Statutes - Title 36. Insurance Page 808

insurer thereof is unable to make payment with respect to the legal

liability of its insured within the limits specified therein because

of insolvency. For the purposes of this coverage the term

"uninsured motor vehicle" shall also include an insured motor

vehicle, the liability limits of which are less than the amount of

the claim of the person or persons making such claim, regardless of

the amount of coverage of either of the parties in relation to each

other.

D. An insurer's insolvency protection shall be applicable only

to accidents occurring during a policy period in which its insured's

uninsured motorist coverage is in effect where the liability insurer

of the tort-feasor becomes insolvent within one (1) year after such

an accident. Nothing herein contained shall be construed to prevent

any insurer from according insolvency protection under terms and

conditions more favorable to its insured than is provided hereunder.

E. For purposes of this section, there is no coverage for any

insured while occupying a motor vehicle owned by, or furnished or

available for the regular use of the named insured, a resident

spouse of the named insured, or a resident relative of the named

insured, if such motor vehicle is not insured by a motor vehicle

insurance policy.

F. In the event of payment to any person under the coverage

required by this section and subject to the terms and conditions of

such coverage, the insurer making such payment shall, to the extent

thereof, be entitled to the proceeds of any settlement or judgment

resulting from the exercise of any rights of recovery of such person

against any person or organization legally responsible for the

bodily injury for which such payment is made, including the proceeds

recoverable from the assets of the insolvent insurer. Provided,

however, with respect to payments made by reason of the coverage

described in subsection C of this section, the insurer making such

payment shall not be entitled to any right of recovery against such

tort-feasor in excess of the proceeds recovered from the assets of

the insolvent insurer of said tort-feasor. Provided further, that

any payment made by the insured tort-feasor shall not reduce or be a

credit against the total liability limits as provided in the

insured's own uninsured motorist coverage. Provided further, that

if a tentative agreement to settle for liability limits has been

reached with an insured tort-feasor, written notice shall be given

by certified mail to the uninsured motorist coverage insurer by its

insured. Such written notice shall include:

1. Written documentation of pecuniary losses incurred,

including copies of all medical bills; and

2. Written authorization or a court order to obtain reports

from all employers and medical providers. Within sixty (60) days of

receipt of this written notice, the uninsured motorist coverage

insurer may substitute its payment to the insured for the tentative

Oklahoma Statutes - Title 36. Insurance Page 809

settlement amount. The uninsured motorist coverage insurer shall

then be entitled to the insured's right of recovery to the extent of

such payment and any settlement under the uninsured motorist

coverage. If the uninsured motorist coverage insurer fails to pay

the insured the amount of the tentative tort settlement within sixty

(60) days, the uninsured motorist coverage insurer has no right to

the proceeds of any settlement or judgment, as provided herein, for

any amount paid under the uninsured motorist coverage.

G. A named insured or applicant shall have the right to reject

uninsured motorist coverage in writing. The form signed by the

insured or applicant which initially rejects coverage or selects

lower limits shall remain valid for the life of the policy and the

completion of a new selection form shall not be required when a

renewal, reinstatement, substitute, replacement, or amended policy

is issued to the same-named insured by the same insurer or any of

its affiliates. Any changes to an existing policy, regardless of

whether these changes create new coverage, do not create a new

policy and do not require the completion of a new form.

After selection of limits, rejection, or exercise of the option

not to purchase uninsured motorist coverage by a named insured or

applicant for insurance, the insurer shall not be required to notify

any insured in any renewal, reinstatement, substitute, amended or

replacement policy as to the availability of such uninsured motorist

coverage or such optional limits. Such selection, rejection, or

exercise of the option not to purchase uninsured motorist coverage

by a named insured or an applicant shall be valid for all insureds

under the policy and shall continue until a named insured requests

in writing that the uninsured motorist coverage be added to an

existing or future policy of insurance.

H. The following are effective on forms required on or after

April 1, 2005. The offer of the coverage required by subsection B

of this section shall be in the following form which shall be filed

with and approved by the Insurance Commissioner. The form shall be

provided to the proposed insured in writing separately from the

application and shall read substantially as follows:

OKLAHOMA UNINSURED MOTORIST COVERAGE LAW

Oklahoma law gives you the right to buy Uninsured Motorist

coverage in the same amount as your bodily injury liability

coverage. THE LAW REQUIRES US TO ADVISE YOU OF THIS VALUABLE RIGHT

FOR THE PROTECTION OF YOU, MEMBERS OF YOUR FAMILY, AND OTHER PEOPLE

WHO MAY BE HURT WHILE RIDING IN YOUR INSURED VEHICLE. YOU SHOULD

SERIOUSLY CONSIDER BUYING THIS COVERAGE IN THE SAME AMOUNT AS YOUR

LIABILITY INSURANCE COVERAGE LIMIT.

Uninsured Motorist coverage, unless otherwise provided in your

policy, pays for bodily injury damages to you, members of your

family who live with you, and other people riding in your car who

are injured by: (1) an uninsured motorist, (2) a hit-and-run

Oklahoma Statutes - Title 36. Insurance Page 810

motorist, or (3) an insured motorist who does not have enough

liability insurance to pay for bodily injury damages to any insured

person. Uninsured Motorist coverage, unless otherwise provided in

your policy, protects you and family members who live with you while

riding in any vehicle or while a pedestrian. THE COST OF THIS

COVERAGE IS SMALL COMPARED WITH THE BENEFITS!

You may make one of four choices about Uninsured Motorist

Coverage by indicating below what Uninsured Motorist coverage you

want:

____ I want the same amount of Uninsured Motorist coverage as my

bodily injury liability coverage.

____ I want minimum Uninsured Motorist coverage $25,000.00 per

person/$50,000.00 per occurrence.

____ I want Uninsured Motorist coverage in the following amount:

$______________ per person/$_________________ per occurrence.

____ I want to reject Uninsured Motorist coverage.

_________________________

Proposed Insured

THIS FORM IS NOT A PART OF YOUR POLICY AND DOES NOT PROVIDE

COVERAGE.

I. The Insurance Commissioner shall approve a deviation from

the form described in subsection H of this section if the form

includes substantially the same information.

J. A change in the bodily injury liability coverage due to a

change in the amount or limits prescribed for bodily injury or death

by a policy meeting the requirements of Section 7-204 of Title 47 of

the Oklahoma Statutes shall not be considered an amendment of the

bodily injury liability coverage and shall not require the

completion of a new form.

K. On the first renewal on or after April 1, 2005, the insurer

shall change the Uninsured Motorist coverage limits to $25,000.00

per person/$50,000.00 per occurrence and charge the corresponding

premium for existing policyholders who have selected Uninsured

Motorist coverage limits less than $25,000.00 per person/$50,000.00

per occurrence. At the first renewal on or after April 1, 2005, the

insurer shall provide existing policyholders who have selected

Uninsured Motorist coverage limits less than $25,000.00 per

person/$50,000.00 per occurrence a notice of the change of their

Uninsured Motorist coverage limits and that notice shall state how

such policyholders may reject Uninsured Motorist coverage limits or

select Uninsured Motorist coverage with limits higher than

$25,000.00 per person/$50,000.00 per occurrence. No notice shall be

required to existing policyholders who have rejected Uninsured

Motorist coverage or have selected Uninsured Motorist coverage

limits equal to or greater than $25,000.00 per person/$50,000.00 per

occurrence. For purposes of this subsection an existing

policyholder is a policyholder who purchased a policy from the

Oklahoma Statutes - Title 36. Insurance Page 811

insurer before April 1, 2005, and such policy renews on or after

April 1, 2005.
Okla. Stat. tit. 36, § 36-2727.1 — OK Code / Title 36 / Section 36-2727.1
Annual license
Status: in_force

Societies which are authorized prior to the effective date of

this act to transact business in this state may continue such

business until the last day of February next succeeding the

effective date of this act. The authority of such societies and of

all societies licensed on and after the effective date of this act

may be renewed annually, to terminate in all cases on the last day

of the succeeding February. However, a license so issued shall

continue in full force and effect until the new license is issued or

specifically refused. For each such license or renewal the society

shall pay to the Insurance Commissioner the fee stated in Section

321 of Title 36 of the Oklahoma Statutes. A duly certified copy or

duplicate of such license shall be prima facie evidence that the

licensee is a fraternal benefit society within the meaning of this

article.
Okla. Stat. tit. 36, § 36-6060.11a — OK Code / Title 36 / Section 36-6060.11a
Procedure to assist plan members in accessing out-of-
Status: in_force

network behavioral health care providers.

A. For the purposes of this act:

1. “Health benefit plan” means a health benefit plan as defined

pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes;

2. “Health care provider” or “provider” means a health care

provider as defined pursuant to Section 6571 of Title 36 of the

Oklahoma Statutes; and

3. “Timely manner” means:

a. for a request for a routine appointment, a provider’s

referral for services, the start of a new treatment or

medication, or other maintenance services, as

determined by the Insurance Department, thirty (30)

days from the date that the insured requests the

appointment, service, or care,

b. for residential care or hospitalization, seven (7)

days from the date that the insured first attempts to

receive care, and

c. for urgent, emergency, or crisis care, twenty-four

(24) hours from the date and time that the insured

first attempts to receive care.

B. A health benefit plan must establish a documented procedure

to assist a plan member in accessing an out-of-network behavioral

Oklahoma Statutes - Title 36. Insurance Page 1108

health care provider when no in-network behavioral health care

provider is available within a timely manner.

C. If the beneficiary of a health benefit plan is unable to

obtain covered behavioral health services from an in-network

provider in a timely manner as defined in subsection A of this

section, including medically appropriate telehealth services, such

plan shall ensure coverage of the behavioral health services from an

out-of-network provider by arranging a network exception with a

negotiated rate from an out-of-network provider. Such an agreement

between the health benefit plan and the out-of-network provider

shall hold the beneficiary harmless for any amount greater than the

in-network cost-sharing amount, including copayment, coinsurance,

and deductible, that the beneficiary would have paid had the same

services been rendered by an in-network provider. The negotiated

rate in the network exception, in addition to the beneficiary's in-

network cost-sharing amount, shall be accepted as payment in full

for the provided behavioral health services. In no instance shall

the beneficiary pay more than the in-network cost-sharing amount for

such services.

D. A plan shall not be held responsible if behavioral health

services are available within a timely manner, as defined in this

section, but the beneficiary chooses to schedule services outside

the timely access standard.

E. A health benefit plan that makes a payment to an out-of-

network provider pursuant to this section shall document the details

of the payment to be made available to the Department upon request

not later than twenty (20) days from the date requested.

F. The Department may promulgate rules to ensure compliance

with and effectuate the provisions of this section.

G. The Insurance Department shall have the authority to

investigate when an insurer has failed to ensure coverage as

required by this section. After the conclusion of an investigation,

the Department may use all available tools to levy fees or fines for

noncompliance.
Okla. Stat. tit. 36, § 36-4030.8 — OK Code / Title 36 / Section 36-4030.8
Present value of paid-up annuity benefit available as
Status: in_force

nonforfeiture option.

For contracts that do not provide cash surrender benefits, the

present value of any paid-up annuity benefit available as a

nonforfeiture option at any time prior to maturity shall not be less

than the present value of that portion of the maturity value of the

paid-up annuity benefit provided under the contract arising from

considerations paid prior to the time the contract is surrendered in

exchange for, or changed to, a deferred paid-up annuity, such

present value being calculated for the period prior to the maturity

date on the basis of the interest rate specified in the contract for

accumulating the net considerations to determine maturity value, and

increased by any existing additional amounts credited by the company

Oklahoma Statutes - Title 36. Insurance Page 856

to the contract. For contracts that do not provide any death

benefits prior to the commencement of any annuity payments, present

values shall be calculated on the basis of such interest rate and

the mortality table specified in the contract for determining the

maturity value of the paid-up annuity benefit. However, in no event

shall the present value of a paid-up annuity benefit be less than

the minimum nonforfeiture amount at that time.
Okla. Stat. tit. 36, § 36-7102 — OK Code / Title 36 / Section 36-7102
Definitions
Status: in_force

As used in the Perpetual Care Fund Act:

1. "Cemetery" or "cemeteries" means any land or structure in

this state dedicated to or used, or intended to be used, for the

interment of human remains;

2. "Burial space" means any grave space, lot, mausoleum crypt

or niche, whether above or below ground, which is used or intended

to be used for the interment of human remains;

Oklahoma Statutes - Title 36. Insurance Page 1480

3. "Purchase price" means the gross dollar amount the customer

shall pay the cemetery under a contractual agreement between the two

to exchange ownership of, or rights to, certain burial spaces.

Purchase price shall not include finance charges, sales tax, charges

for credit life insurance, opening and closing costs and setting

fees, but shall include any amount which the customer is required to

pay as a deposit to the Perpetual Care Fund, described in Section

7103 of this title. On sales of burial spaces wherein discounts or

free spaces are granted to the customer by the cemetery, the

purchase price shall be the fair market value or the normal selling

price of that particular type of burial space as sold by the

cemetery;

4. "Financial institution" means a federally insured bank or

savings and loan authorized to exercise trust powers or a trust

company that is authorized to do business in this state;

5. "Income", except as provided in subsection D of Section 7103

of this title, means the return derived from the principal amount,

excluding capital gains;

6. "Insurance Commissioner" or "Commissioner" means the

Insurance Commissioner of the State of Oklahoma; and

7. "Designated agent" means one or more individuals designated

by the cemetery owner and whom the owner has acknowledged as having

fiduciary responsibilities under the Perpetual Care Fund Act.
Okla. Stat. tit. 36, § 36-6512 — OK Code / Title 36 / Section 36-6512
Definitions
Status: in_force

As used in the Small Employer Health Insurance Reform Act:

1. "Actuarial certification" means a written statement by a

member of the American Academy of Actuaries or other individual

acceptable to the Insurance Commissioner that a small employer

carrier is in compliance with the provisions of Section 6515 of this

title, based upon the examination of the person, including a review

of the appropriate records and of the actuarial assumptions and

methods used by the small employer carrier in establishing premium

rates for applicable health benefit plans;

2. "Affiliate" or "affiliated" means any entity or person who

directly or indirectly through one or more intermediaries, controls

or is controlled by, or is under common control with, a specified

entity or person;

3. "Base premium rate" means, for each class of business as to

a rating period, the lowest premium rate charged or which could have

been charged under a rating system for that class of business, by

the small employer carrier to small employers with similar case

characteristics for health benefit plans with the same or similar

coverage;

4. "Basic health benefit plan" means a lower cost health

benefit plan adopted by the state for small employer groups;

5. "Board" means the board of directors of the program

established pursuant to Section 6522 of this title;

6. "Carrier" means any entity which provides health insurance

in this state. For the purposes of the Small Employer Health

Insurance Reform Act, carrier includes a licensed insurance company,

not-for-profit hospital service or medical indemnity corporation, a

fraternal benefit society, a health maintenance organization, a

multiple employer welfare arrangement or any other entity providing

a plan of health insurance or health benefits subject to state

insurance regulation;

7. "Case characteristics" means demographic or other objective

characteristics of a small employer that are considered by the small

employer carrier in the determination of premium rates for the small

employer, provided that claim experience, health status and duration

of coverage shall not be case characteristics for the purposes of

the Small Employer Health Insurance Reform Act. A small employer

carrier shall not use case characteristics, other than age, gender,

industry, geographic area and family composition, without prior

approval of the Insurance Commissioner. Group size shall not be

used as a case characteristic;

Oklahoma Statutes - Title 36. Insurance Page 1273

8. "Class of business" means all or a separate grouping of

small employers established pursuant to Section 6514 of this title.

Group size shall not be used as a class of business;

9. "Commissioner" means the Insurance Commissioner;

10. "Control", "controlling", "controlled by" or "under common

control with" means the possession, direct or indirect, of the power

to direct or cause the direction of the management and policies of a

person, whether through the ownership of voting securities, by

contract or otherwise, unless the power is the result of an official

position with or corporate office held by the person. Control shall

be presumed to exist if any person, directly or indirectly, owns,

controls, holds with the power to vote, or holds proxies

representing ten percent (10%) or more of the voting securities of

any other person. This presumption may be rebutted by a showing

that control does not exist in fact in the manner provided in

Section 1654 of this title. The Commissioner may determine, after

furnishing all persons in interest notice and opportunity to be

heard and making specific findings of fact to support the

determination, that control exists in fact, notwithstanding the

absence of a presumption to that effect;

11. "Department" means the Insurance Department;

12. "Dependent" means a spouse, an unmarried child under the

age of eighteen (18), an unmarried child who is a full-time student

under the age of twenty-three (23) and who is financially dependent

upon the parent, and an unmarried child of any age who is medically

certified as disabled and dependent upon the parent;

13. "Eligible employee" means an employee who works on a full-

time basis or, at the option of the employer, an employee who works

on a part-time basis with a normal work week of twenty-four (24) or

more hours. The term includes a sole proprietor, a partner of a

partnership, and associates of a limited liability company, if the

sole proprietor, partner or associate is included as an employee

under a health benefit plan of a small employer, but does not

include an employee who works on a temporary or substitute basis;

14. "Established geographic service area" means a geographic

area, as approved by the Commissioner and based on the certificate

of authority of the carrier to transact insurance in this state,

within which the carrier is authorized to provide coverage;

15. a. "Health benefit plan" means any hospital or medical

policy or certificate; contract of insurance provided

by a not-for-profit hospital service or medical

indemnity plan; or prepaid health plan or health

maintenance organization subscriber contract.

b. Health benefit plan does not include accident-only,

credit, dental, vision, Medicare supplement, long-term

care, or disability income insurance, coverage issued

as a supplement to liability insurance, workers'

Oklahoma Statutes - Title 36. Insurance Page 1274

compensation or similar insurance, or automobile

medical payment insurance.

c. "Health benefit plan" shall not include policies or

certificates of specified disease, hospital

confinement indemnity or limited benefit health

insurance, provided that the carrier offering those

policies or certificates complies with the following:

(1) the carrier files on or before March 1 of each

year a certification with the Commissioner that

contains the statement and information described

in division (2) of this subparagraph,

(2) the certification required in division (1) of

this subparagraph shall contain the following:

(a) a statement from the carrier certifying that

policies or certificates described in this

subparagraph are being offered and marketed

as supplemental health insurance and not as

a substitute for hospital or medical expense

insurance or major medical expense

insurance, and

(b) a summary description of each policy or

certificate described in this subparagraph,

including the average annual premium rates

or range of premium rates in cases where

premiums vary by age, gender or other

factors charged for such policies and

certificates in this state, and

(3) in the case of a policy or certificate that is

described in this subparagraph and that is

offered for the first time in this state on or

after May 20, 1994, the carrier files with the

Commissioner the information and statement

required in division (2) of this subparagraph at

least thirty (30) days prior to the date a policy

or certificate is issued or delivered in this

state;

16. "Index rate" means, for each class of business as to a

rating period for small employers with similar case characteristics,

the arithmetic average of the applicable base premium rate and the

corresponding highest premium rate;

17. "Late enrollee" means an eligible employee or dependent who

requests enrollment in a health benefit plan of a small employer

following the initial enrollment period during which the individual

is entitled to enroll under the terms of the health benefit plan,

provided that the initial enrollment period is a period of at least

thirty-one (31) days. However, an eligible employee or dependent

shall not be considered a late enrollee if:

Oklahoma Statutes - Title 36. Insurance Page 1275

a. the individual meets each of the following:

(1) the individual was covered under qualifying

previous coverage at the time of the initial

enrollment,

(2) the individual lost coverage under qualifying

previous coverage as a result of termination of

employment or eligibility, the involuntary

termination of the qualifying previous coverage,

death of a spouse or divorce, and

(3) the individual requests enrollment within thirty

(30) days after termination of the qualifying

previous coverage,

b. the individual is employed by an employer which offers

multiple health benefit plans and the individual

elects a different plan during an open enrollment

period, or

c. a court has ordered coverage be provided for a spouse

or minor or dependent child under a health benefit

plan of a covered employee and request for enrollment

is made within thirty (30) days after issuance of the

court order;

18. "New business premium rate" means, for each class of

business as to a rating period, the lowest premium rate charged or

offered, or which could have been charged or offered, by the small

employer carrier to small employers with similar case

characteristics for newly issued health benefit plans with the same

or similar coverage;

19. "Premium" means all monies paid by a small employer and

eligible employees as a condition of receiving coverage from a small

employer carrier, including any fees or other contributions

associated with the health benefit plan;

20. "Program" means the Oklahoma Small Employer Health

Reinsurance Program created pursuant to Section 6522 of this title;

21. "Qualifying previous coverage" and "qualifying existing

coverage" mean benefits or coverage provided under:

a. Medicare or Medicaid,

b. an employer-based health insurance or health benefit

arrangement that provides benefits similar to or

exceeding benefits provided under the basic health

benefit plan, or

c. an individual health insurance policy, including

coverage issued by a health maintenance organization,

fraternal benefit society and those entities set forth

in Sections 6901 through 6936 of this title, that

provides benefits similar to or exceeding the benefits

provided under the basic health benefit plan, provided

Oklahoma Statutes - Title 36. Insurance Page 1276

that the policy has been in effect for a period of at

least one (1) year;

22. "Rating period" means the calendar period for which premium

rates established by a small employer carrier are assumed to be in

effect;

23. "Reinsuring carrier" means a small employer carrier

participating in the reinsurance program pursuant to Section 6522 of

this title;

24. "Restricted network provision" means any provision of a

health benefit plan that conditions the payment of benefits, in

whole or in part, on the use of health care providers that have

entered into a contractual arrangement with the carrier pursuant to

Sections 6901 through 6963 of this title to provide health care

services to covered individuals;

25. "Small employer" means any person, firm, corporation,

partnership, limited liability company or association that is

actively engaged in business that, on at least fifty percent (50%)

of its working days during the preceding calendar quarter, employed

no more than fifty (50) eligible employees, the majority of whom

were employed within this state. In determining the number of

eligible employees, companies that are affiliated companies, or that

are eligible to file a combined tax return for purposes of state

income taxation, shall be considered one employer; and

26. "Small employer carrier" means a carrier that offers health

benefit plans covering eligible employees of one or more small

employers in this state.
Okla. Stat. tit. 36, § 36-4430 — OK Code / Title 36 / Section 36-4430
Renewal premium rates
Status: in_force

A. Upon approval of the Insurance Commissioner, an insurer may

charge an increased renewal premium upon showing that the increase

is necessary because of utilization of policy benefits in excess of

the expected rate.

B. 1. This section does not apply to life insurance policies or

riders containing accelerated long-term care benefits.

2. For certificates issued or delivered on or after November 1,

1995, under a group long-term care insurance policy as defined in

Section 4424 of this title, which policy was in force on November 1,

1995, the provisions of this section shall not apply.

Oklahoma Statutes - Title 36. Insurance Page 977

3. This section does not apply to policies or certificates

approved for issue or delivery on or after November 1, 2001.
Okla. Stat. tit. 36, § 36-3301 — OK Code / Title 36 / Section 36-3301
Short title - Own Risk and Solvency Assessment (ORSA)
Status: in_force

Act.

This act shall be known and may be cited as the "Own Risk and

Solvency Assessment (ORSA) Act".
Okla. Stat. tit. 36, § 36-4405 — OK Code / Title 36 / Section 36-4405
Accident and health policy provisions
Status: reserved

A. Required Provisions. Except as provided in subsection D of

this section, each such policy delivered or issued for delivery to

any person in this state shall contain the provisions specified in

this subsection in the words in which the same appear in this

section; provided, however, that the insurer may, at its option,

Oklahoma Statutes - Title 36. Insurance Page 940

substitute for one or more of such provisions corresponding

provisions of different wording approved by the Insurance

Commissioner which are in each instance not less favorable in any

respect to the insured or the beneficiary. Such provisions shall be

preceded individually by the caption appearing in this subsection

or, at the option of the insurer, by such appropriate individual or

group captions or subcaptions as the Insurance Commissioner may

approve.

1. A provision as follows: ENTIRE CONTRACT; CHANGES: This

policy, including the endorsements and the attached papers, if any,

constitutes the entire contract of insurance. No change in this

policy shall be valid until approved by an executive officer of the

insurer and unless such approval be endorsed hereon or attached

hereto. No agent has authority to change this policy or to waive

any of its provisions.

2. A provision as follows: TIME LIMIT ON CERTAIN DEFENSES:

(a) After two (2) years from the date of issue of this policy,

no misstatements, except fraudulent misstatements, made by the

applicant in the application for such policy shall be used to void

the policy or to deny a claim for loss incurred or disability (as

defined in the policy) commencing after the expiration of such two-

year period. The foregoing policy provision shall not be so

construed as to affect any legal requirement for avoidance of a

policy or denial of a claim during such initial two-year period, nor

limit the application of paragraphs 1, 2, 3, 4 and 5 of subsection B

of this section in the event of misstatement with respect to age or

occupation or other insurance. A policy which the insured has the

right to continue in force subject to its terms by the timely

payment of premium (i) until at least fifty (50) years of age or,

(ii) in the case of a policy issued to a person older than forty-

four (44) years of age, for at least five (5) years from its date of

issue, may contain in lieu of the foregoing the following provisions

(from which the clause in parentheses may be omitted at the

insurer's option) under the caption "Incontestable". After this

policy has been in force for a period of two (2) years during the

lifetime of the insured (excluding any period during which the

insured is disabled), it shall become incontestable as to the

statements contained in the application.

(b) No claim for loss incurred or disability (as defined in the

policy) commencing after two (2) years from the date of issue of

this policy shall be reduced or denied on the ground that a disease

or physical condition not excluded from coverage by name or specific

description effective on the date of loss had existed prior to the

effective date of coverage of this policy.

3. A provision as follows: GRACE PERIOD:

(a) A grace period of ______ (insert a number not less than "7"

for weekly premium policies, "10" for monthly premium policies and

Oklahoma Statutes - Title 36. Insurance Page 941

"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.

(b) 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."

4. A provision as follows: REINSTATEMENT:

(a) If any renewal premium be not paid within the time granted

the insured for payment, a subsequent acceptance of premium by the

insurer or by any agent duly authorized by the insurer to accept

such premium, without requiring in connection therewith an

application for reinstatement, shall reinstate the policy; provided,

however, that if the insurer or such agent requires an application

for reinstatement and issues a conditional receipt for the premium

tendered, the policy will be reinstated upon approval of such

application by the insurer or, lacking such approval, upon the

forty-fifth day following the date of such conditional receipt,

unless the insurer has previously notified the insured in writing of

its disapproval of such application. The reinstated policy shall

cover only loss resulting from such accidental injury as may be

sustained after the date of reinstatement and loss due to such

sickness as may begin more than ten (10) days after such date. In

all other respects the insured and insurer shall have the same

rights thereunder as they had under the policy immediately before

the due date of the defaulted premium, subject to any provisions

endorsed hereon or attached hereto in connection with the

reinstatement. Any premium accepted in connection with a

reinstatement shall be applied to a period for which premium has not

been previously paid, but not to any period more than sixty (60)

days prior to the date of reinstatement.

(b) The last sentence of the above provision may be omitted from

any policy which the insured has the right to continue in force

subject to its terms by the timely payment of premiums (i) until at

least fifty (50) years of age or, (ii) in the case of a policy

issued to a person older than forty-four (44) years of age, for at

least five (5) years from its date of issue.

5. A provision as follows: NOTICE OF CLAIM:

(a) Written notice of claim must be given to the insurer within

twenty (20) days after the occurrence or commencement of any loss

covered by the policy, or as soon thereafter as is reasonably

possible. Notice given by or on behalf of the insured or the

beneficiary to the insurer at ______ (insert the location of such

office as the insurer may designate for the purpose), or to any

Oklahoma Statutes - Title 36. Insurance Page 942

authorized agent of the insurer, with information sufficient to

identify the insured, shall be deemed notice to the insurer.

(b) In a policy providing a loss-of-time benefit which may be

payable for at least two (2) years, an insurer may, at its option,

insert the following between the first and second sentences of the

above provision: Subject to the qualifications set forth below, if

the insured suffers loss of time on account of disability for which

indemnity may be payable for at least two (2) years, he shall, at

least once in every six (6) months after having given notice of

claim, give to the insurer notice of continuance of said disability

except in the event of legal incapacity. The period of six (6)

months following any filing of proof by the insured or any payment

by the insurer on account of such claim or any denial of liability

in whole or in part by the insurer shall be excluded in applying

this provision. Delay in the giving of such notice shall not impair

the insured's right to any indemnity which would otherwise have

accrued during the period of six (6) months preceding the date on

which such notice is actually given.

6. A provision as follows: CLAIM FORMS: The insurer, upon

receipt of a notice of claim, will furnish to the claimant such

forms as are usually furnished by it for filing proofs of loss. If

such forms are not furnished within fifteen (15) days after the

giving of such notice, the claimant shall be deemed to have complied

with the requirements of this policy as to proof of loss upon

submitting, within the time fixed in the policy for filing proofs of

loss, written proof covering the occurrence, the character and the

extent of the loss for which claim is made.

7. A provision as follows: PROOFS OF LOSS: Written proof of

loss must be furnished to the insurer at its said office in case of

claim for loss for which the policy provides any periodic payment

contingent upon continuing loss within ninety (90) days after the

termination of the period for which the insurer is liable and in

case of claim for any other loss within ninety (90) days after the

date of such loss. Failure to furnish such proof within the time

required shall not invalidate nor reduce any claim if it was not

reasonably possible to give proof within such time, provided such

proof is furnished as soon as reasonably possible and in no event,

except in the absence of legal capacity, later than one (1) year

from the time proof is otherwise required.

8. A provision as follows: TIME OF PAYMENT OF CLAIMS:

Indemnities payable under this policy for any loss other than loss

for which this policy provides any periodic payment will be paid

immediately upon receipt of due written proof of such loss. Subject

to due written proof of loss, all accrued indemnities for loss for

which this policy provides periodic payment will be paid______

(insert period for payment which must not be less frequently than

monthly) and any balance remaining unpaid upon the termination of

Oklahoma Statutes - Title 36. Insurance Page 943

liability will be paid immediately upon receipt of due written

proof.

9. A provision as follows: PAYMENT OF CLAIMS:

(a) Indemnity for loss of life will be payable in accordance

with the beneficiary designation and the provisions respecting such

payment which may be prescribed herein and effective at the time of

payment. If no such designation or provision is then effective,

such indemnity shall be payable to the estate of the insured. Any

other accrued indemnities unpaid at the insured's death may, at the

option of the insurer, be paid either to such beneficiary or to such

estate. All other indemnities will be payable to the insured.

(b) The following provisions, or either of them, may be included

with the foregoing provision at the option of the insurer: If any

indemnity of this policy shall be payable to the estate of the

insured, or to an insured or beneficiary who is a minor or otherwise

not competent to give a valid release, the insurer may pay such

indemnity, up to an amount not exceeding $______ (insert an amount

which shall not exceed One Thousand Dollars ($1,000.00)), to any

relative by blood or connection by marriage of the insured or

beneficiary who is deemed by the insurer to be equitably entitled

thereto. Any payment made by the insurer in good faith pursuant to

this provision shall fully discharge the insurer to the extent of

such payment.

Subject to any written direction of the insured in the

application or otherwise, all or a portion of any indemnities

provided by this policy on account of hospital, nursing, medical, or

surgical services may, at the insurer's option and unless the

insured requests otherwise in writing not later than the time of

filing proofs of such loss, be paid directly to the hospital or

person rendering such services; but it is not required that the

service be rendered by a particular hospital or person.

10. A provision as follows: PHYSICAL EXAMINATION, AUTOPSY:

The insurer at its own expense shall have the right and

opportunity to examine the person of the insured when and as often

as it may reasonably require during the pendency of a claim

hereunder and to make an autopsy in case of death where it is not

forbidden by law.

11. A provision as follows: LEGAL ACTIONS: No action at law

or in equity shall be brought to recover on this policy prior to the

expiration of sixty (60) days after written proof of loss has been

furnished in accordance with the requirements of this policy. No

such action shall be brought after the expiration of three (3) years

after the time written proof of loss is required to be furnished.

12. A provision as follows: CHANGE OF BENEFICIARY: Unless the

insured makes an irrevocable designation of beneficiary, the right

to change of beneficiary is reserved to the insured and the consent

of the beneficiary or beneficiaries shall not be requisite to

Oklahoma Statutes - Title 36. Insurance Page 944

surrender or assignment of this policy or to any change of

beneficiary or beneficiaries, or to any other changes in this

policy.

The first clause of this provision, relating to the irrevocable

designation of beneficiary, may be omitted at the insurer's option.

B. Other provisions. Except as provided in subsection D of

this section, no such policy delivered or issued for delivery to any

person in this state shall contain provisions respecting the matters

set forth below unless such provisions are in the words in which the

same appear in this section; provided, however, that the insurer

may, at its option, use in lieu of any such provision a

corresponding provision of different wording approved by the

Insurance Commissioner which is not less favorable in any respect to

the insured or the beneficiary. Any such provision contained in the

policy shall be preceded individually by the appropriate caption

appearing in this subsection or, at the option of the insurer, by

such appropriate individual or group captions or subcaptions as the

Insurance Commissioner may approve.

1. A provision as follows: CHANGE OF OCCUPATION: If the

insured be injured or contract sickness after having changed his

occupation to one classified by the insurer as more hazardous than

that stated in this policy or while doing for compensation anything

pertaining to an occupation so classified, the insurer will pay only

such portion of the indemnities provided in this policy as the

premium paid would have purchased at the rates and within the limits

fixed by the insurer for such more hazardous occupation. If the

insured changes his occupation to one classified by the insurer as

less hazardous than that stated in this policy, the insurer, upon

receipt of proof of such change of occupation, will reduce the

premium rate accordingly, and will return the excess pro rata

unearned premium from the date of change of occupation or from the

policy anniversary date immediately preceding receipt of such proof,

whichever is the more recent. In applying this provision, the

classification of occupational risk and the premium rates shall be

such as have been last filed by the insurer prior to the occurrence

of the loss for which the insurer is liable or prior to date of

proof of change in occupation with the state official having

supervision of insurance in the state where the insured resided at

the time this policy was issued; but if such filing was not

required, then the classification of occupational risk and the

premium rates shall be those last made effective by the insurer in

such state prior to the occurrence of the loss or prior to the date

of proof of change of occupation.

2. A provision as follows: MISSTATEMENT OF AGE: If the age of

the insured has been misstated, all amounts payable under this

policy shall be such as the premium paid would have purchased at the

correct age.

Oklahoma Statutes - Title 36. Insurance Page 945

3. A provision as follows: OTHER INSURANCE IN THIS INSURER:

If an accident or health or accident and health policy or

policies previously issued by the insurer to the insured be in force

concurrently herewith, making the aggregate indemnity for______

(insert type of coverage or coverages) in excess of $______ (insert

maximum limit of indemnity or indemnities), the excess insurance

shall be void and all premiums paid for such excess shall be

returned to the insured or to his estate; or, in lieu thereof:

Insurance effective at any one time on the insured under a like

policy or policies in this insurer is limited to the one such policy

elected by the insured, his beneficiary or his estate, as the case

may be, and the insurer will return all premiums paid for all other

such policies.

4. A provision as follows: INSURANCE WITH OTHER INSURERS:

(a) If there be other valid coverage, not with this insurer,

providing benefits for the same loss on a provision of service basis

or on an expense incurred basis and of which this insurer has not

been given written notice prior to the occurrence or commencement of

loss, the only liability under any expense incurred coverage of this

policy shall be for such proportion of the loss as the amount which

would otherwise have been payable hereunder plus the total of the

like amounts under all such other valid coverages for the same loss

of which this insurer had notice bears to the total like amounts

under all valid coverages for such loss, and for the return of such

portion of the premiums paid as shall exceed the pro rata portion

for the amount so determined. For the purpose of applying this

provision when other coverage is on a provision of service basis,

the "like amount" of such other coverage shall be taken as the

amount which the services rendered would have cost in the absence of

such coverage.

(b) If the foregoing policy provision is included in a policy

which also contains the next following policy provision, there shall

be added to the caption of the foregoing provision the phrase

"Expense Incurred Benefits". The insurer may, at its option,

include in this provision a definition of "other valid coverage",

approved as to form by the Insurance Commissioner, which definition

shall be limited in subject matter to coverage provided 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, and by hospital or medical service

organizations, and to any other coverage the inclusion of which may

be approved by the Insurance Commissioner. In the absence of such

definition such term shall not include group insurance, automobile

medical payments insurance, or coverage provided by hospital or

medical service organizations or by union welfare plans or employer

or employee benefit organizations. For the purpose of applying the

foregoing policy provision with respect to any insured, any amount

Oklahoma Statutes - Title 36. Insurance Page 946

of benefit provided for such insured pursuant to any compulsory

benefit statute (including any workers' compensation or employer's

liability statute), whether provided by a governmental agency or

otherwise, shall in all cases be deemed to be "other valid coverage"

of which the insurer has had notice. In applying the foregoing

policy provision no third party liability coverage shall be included

as "other valid coverage".

5. A provision as follows: INSURANCE WITH OTHER INSURERS:

(a) If there be other valid coverage, not with this insurer,

providing benefits for the same loss on other than an expense

incurred basis and of which this insurer has not been given written

notice prior to the occurrence or commencement of loss, the only

liability for such benefits under this policy shall be for such

portion of the indemnities otherwise provided hereunder for such

loss as the like indemnities, of which the insurer had notice

(including the indemnities under this policy), bear to the total

amount of all like indemnities for such loss, and for the return of

such portion of the premium paid as shall exceed the pro rata

portion for the indemnities thus determined.

(b) If the foregoing policy provision is included in a policy

which also contains the next preceding policy provision, there shall

be added to the caption of the foregoing provision the phrase "Other

Benefits". The insurer may, at its option, include in this

provision a definition of "other valid coverage", approved as to

form by the Insurance Commissioner, which definition shall be

limited in subject matter to coverage provided 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, and to any other coverage the inclusion of which may be

approved by the Insurance Commissioner. In the absence of such

definition, such term shall not include group insurance or benefits

provided by union welfare plans or by employer or employee benefit

organizations. For the purpose of applying the foregoing policy

provision with respect to any insured, any amount of benefit

provided for such insured pursuant to any compulsory benefit statute

(including any workers' compensation or employer's liability

statute) whether provided by a governmental agency or otherwise,

shall in all cases be deemed to be "other valid coverage" of which

the insurer has had notice. In applying the foregoing policy

provision, no third party liability coverage shall be included as

"other valid coverage".

6. A provision as follows: RELATION OF EARNINGS TO INSURANCE:(a) 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 (2) years immediately

preceding a disability for which claim is made, whichever is the

greater, the insurer will be liable only for such proportionate

Oklahoma Statutes - Title 36. Insurance Page 947

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 (2) 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 benefits payable under all

such coverage upon the insured below the sum of Two Hundred Dollars

($200.00) 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.

(b) 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 (i) until at least

fifty (50) years of age or, (ii) in the case of a policy issued to a

person older than forty-four (44) years of age, 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 Insurance Commissioner, 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

Insurance Commissioner 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 workers' compensation or employer's liability

statute), or benefits provided by union welfare plans or by employer

or employee benefit organizations.

7. A provision as follows: UNPAID PREMIUM: Upon the payment

of a claim under this policy, any premium then due and unpaid or

covered by any note or written order may be deducted therefrom.

8. A provision as follows: CONFORMITY WITH STATE STATUTES: Any

provision of this policy which, on its effective date, is in

conflict with the statutes of the state in which the insured resides

on such date is hereby amended to conform to the minimum

requirements of such states.

9. A provision as follows: ILLEGAL OCCUPATION: The insurer

shall not be liable for any loss to which a contributing cause was

the insured's commission of or attempt to commit a felony or to

which a contributing cause was the insured's being engaged in an

illegal occupation.

10. A provision as follows: NARCOTICS: The insurer shall not

be liable for any loss sustained or contracted in consequence of the

Oklahoma Statutes - Title 36. Insurance Page 948

insured's being under the influence of any narcotic unless

administered on the advice of a physician.

11. A provision as follows: CONTINUITY OF COVERAGE: If

coverage otherwise terminates as to covered family members, other

than for nonpayment of premium, nonrenewal of the policy or the

expiration of the term for which the policy is issued, a covered

person (other than one eligible for Medicare or any other similar

federal program), including the spouse and any covered dependent

child of the last-named insured or the representative of such child,

shall have the right to the continuation of coverage under

provisions which, at the option of the insurer, are consistent with

either the continuation of the policy with the person exercising the

right of continuation designated as the named insured; or the

issuance of a converted policy with the person exercising the

conversion right designated as the named insured. Where

continuation of coverage or conversion is made in the name of the

spouse of the named insured, such coverage may, at the option of

such spouse, include covered dependent children for whom such spouse

has responsibility for care and support. The person who accepts the

conversion policy shall become the insured and pay the premiums

direct to the insurer.

(a) Coverage continued through the issuance of a converted

policy shall consist of a form of coverage then being offered by the

insurer as a conversion policy in the jurisdiction where the person

exercising the conversion right resides. Continued and converted

coverages, other than those provided through the exercise of

continuation or conversion rights contained in optionally renewable

or limited right of renewal contracts, shall contain provisions

under which the person exercising the continuation or conversion

shall have the right to renew the coverage until the attainment of

the age of eligibility for Medicare or any other similar federal or

state health insurance program subject to the right of the insurer

to nonrenew all such policies in this state as a class, or, other

renewal provisions that are not less favorable to the insured than

those contained in the policy from which conversion is exercised.

(b) Coverage provided through continuation or conversion shall

be without additional evidence of insurability except as to

overinsurance, and shall not impose any preexisting condition

limitations or other contractual time limitations other than those

remaining unexpired under the policy or contract from which

continuation or conversion is exercised.

(c) Benefits otherwise payable under a converted policy may be

reduced so they are not, during the first policy year of the

converted policy, in excess of those that would have been payable

had the coverage under the policy from which conversion is exercised

not terminated, and by the amount of benefits, if any, payable as to

the same loss under the policy from which conversion is exercised.

Oklahoma Statutes - Title 36. Insurance Page 949

(d) The insurer shall not be required to issue a converted

policy if at the time of application therefor other coverage exists

under other health insurance policies, hospital or medical service

plan corporation contracts, health maintenance organization plans or

self-insured health benefit plans providing similar benefits, or if

the applicant for the converted policy is eligible for coverage

under a group policy or contract providing similar benefits, or is

provided with similar benefits required by any statute, or is

covered under any national, state or governmental plan, which

together with the converted policy would result in overinsurance

according to the insurer's underwriting standards.

The provisions of this paragraph shall apply to individual

family health insurance policies providing hospital, surgical and

medical expense benefits or hospital confinement indemnity benefits,

individual family hospital and medical service plan corporation

contracts, and family health maintenance organization contracts,

delivered or issued for delivery in the State of Oklahoma but shall

not apply to disability income policies, accidental death or

dismemberment policies nor to single-term, nonrenewable policies.

C. 1. The terms "noncancelable" and "guaranteed renewable" may

be used only in a policy which the insured has the right to continue

in force by the timely payment of premiums set forth in the policy

until a person is at least fifty (50) years of age, or in the case

of a policy issued to a person older than forty-four (44) years of

age, for at least five (5) years from its date of issue, during

which period the insurer has no right to make unilaterally any

change in any provision of the policy while the policy is in force.

2. Except as provided in paragraph 1 of this subsection, the

term "guaranteed renewable" may be used only in a policy which the

insured has the right to continue in force by the timely payment of

premiums by the insured until fifty (50) years of age, or in the

case of a policy issued to an insured who is older than forty-four

(44) years of age, for at least five (5) years from its date of

issue, during which period the insurer has no right to make

unilaterally any change in any provision of the policy while the

policy is in force, except that the insurer may make changes in

premium rates by classes.

The foregoing limitation on the use of the term "noncancelable"

shall also apply to any synonymous term such as "guaranteed

continuable".

Nothing contained in this subsection is intended to restrict the

development of policies having other guarantees of renewability, or

to prevent the accurate description of their terms of renewability

or the classification of such policies as guaranteed renewable or

noncancelable for any period during which they may actually be such,

provided the terms used to describe them in policy contracts and

Oklahoma Statutes - Title 36. Insurance Page 950

advertising are not such as may readily be confused with the above

terms.

D. Inapplicable or Inconsistent Provisions. If any provision

of this section is in whole or in part inapplicable to or

inconsistent with the coverage provided by a particular form of

policy, the insurer, with the approval of the Insurance

Commissioner, shall omit from such policy any inapplicable provision

or part of a provision, and shall modify any inconsistent provision

or part of the provision in such manner as to make the provision as

contained in the policy consistent with the coverage provided by the

policy.

E. Order of Certain Policy Provisions. The provisions which

are the subject of subsections A and B of this section, or any

corresponding provisions which are used in lieu thereof in

accordance with such subsections, shall be printed in the

consecutive order of the provisions in such subsections or, at the

option of the insurer, any such provision may appear as a unit in

any part of the policy, with other provisions to which it may be

logically related, provided the resulting policy shall not be in

whole or in part unintelligible, uncertain, ambiguous, abstruse, or

likely to mislead a person to whom the policy is offered, delivered

or issued.

F. Third Party Ownership. The word "insured", as used in this

article, shall not be construed as preventing a person other than

the insured with a proper insurable interest from making application

for and owning a policy covering the insured or from being entitled

under such a policy to any indemnities, benefits and rights provided

therein.

G. Employer Designated as Beneficiary. No employer shall be

designated or appointed as beneficiary of an employee or receive any

benefits under an individual or group accident and health policy

solely by reason of the employer-employee relationship; provided,

however, this subsection shall not prevent the designation or

appointment of an employer as beneficiary under a policy of accident

and health insurance on any valuable or key employee of such

employer.

H. 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 article and which is prescribed or required by the law of

the state 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.

I. Filing Procedure. The Insurance Commissioner may make such

reasonable rules and regulations concerning the procedure for the

Oklahoma Statutes - Title 36. Insurance Page 951

filing or submission of policies subject to this article as are

necessary, proper or advisable to the administration of this

article. This provision shall not abridge any other authority

granted the Insurance Commissioner by law.
Okla. Stat. tit. 36, § 36-2512 — OK Code / Title 36 / Section 36-2512
Amendment of articles of incorporation to conform to
Status: in_force

general insurance law.

Any domestic life or accident and health insurance corporation,

company or association existing or doing business in this state

under the stipulated premium plan law on April 9, 1923, may, by

majority vote of its board of directors or trustees, accept the

provisions of this article, the same as if it had originally been

incorporated thereunder, and shall submit a record of the

proceedings of its board of directors or trustees, together with the

amended articles, to the Insurance Commissioner, for his examination

and approval of the legal form thereof, and shall file such amended

articles in the office of the Secretary of State and a certified

copy of same in the office of the Insurance Commissioner, and

deposit with the State Treasurer such securities as may be required

of corporations originally incorporated under this article.

Insurance corporations, companies and associations complying with

the provisions of this section shall thereafter enjoy and exercise

all of the rights and privileges accorded by law to companies

originally incorporated under this article. Compliance with this

section shall in nowise annul, modify or change any of the existing

contracts or obligations of the corporation, and any and all such

contracts and liabilities shall continue in force and effect the

same as if such corporation had not reincorporated under the

provisions of this section. Compliance with the provisions of this

section shall in no way prejudice, impede or impair any pending

action, proceeding or rights previously acquired.
Okla. Stat. tit. 36, § 36-7201 — OK Code / Title 36 / Section 36-7201
Definitions
Status: in_force

As used in this act:

1. “Access payments” means an amount paid to the Insurance

Commissioner based upon a percentage of claims paid by a health

carrier to be used to fund the state’s Medicaid program and make

full use of any federal matching funds available to the state;

2. “Claims paid” means all payments made by a health carrier

for health and medical services for residents of this state.

“Claims paid” shall not include:

a. claims-related expenses and general administrative

expenses,

b. payments made to qualifying providers under a “pay-

for-performance” or other incentive compensation

arrangement if the payments are not reflected in the

Oklahoma Statutes - Title 36. Insurance Page 1498

processing of claims submitted for services rendered

to specific covered individuals,

c. claims paid by health carriers with respect to

accidental injury, specified disease, hospital

indemnity, dental, vision, disability income, long-

term care, Medicare supplement or other limited

benefit health insurance, except claims paid for

dental services covered under a medical policy,

d. claims paid for services rendered to nonresidents of

this state,

e. claims paid under retiree health benefit plans that

are separate from and not included within benefit

plans for existing employees,

f. claims paid by an employee benefit excess insurance

carrier that have been counted by a third-party

administrator for determining an access payment,

g. claims paid for services rendered to a person covered

under a benefit plan for federal employees,

h. claims paid for services rendered outside of this

state to a person who is a resident of this state, and

i. claims paid pursuant to Medicare or Medicaid;

3. “Claims-related expenses” means:

a. payments for utilization review, care management,

disease management, risk assessment and similar

administrative services intended to reduce the claims

paid for health and medical services rendered to cover

individuals for the purposes of attempting to ensure

that needed services are delivered in an efficacious

manner or by helping to maintain or improve the health

of a covered individual, and

b. payments made to or by organized groups of providers

of health and medical services in accordance with

managed care risk arrangements or network access

agreements that are unrelated to the provision of

services to specific covered individuals;

4. “Health and medical services” means, but is not limited to:

a. any services included in the furnishing of medical

care,

b. dental care to the extent covered under a medical

insurance policy,

c. pharmaceutical benefits or hospitalization, including,

but not limited to, services provided in a hospital or

other medical facility,

d. ancillary services, including, but not limited to,

ambulatory services,

Oklahoma Statutes - Title 36. Insurance Page 1499

e. physician and other practitioner services, including,

but not limited to, services provided by an assistant

to a physician, nurse practitioner or midwife, and

f. behavioral health services, including, but not limited

to, mental health and substance abuse services;

5. “Health carrier” means any entity or insurer authorized to

provide health insurance or health benefits pursuant to the laws of

this state and any entity or person engaged in the business of

making contracts of accident or health insurance. “Health carrier”

includes, but is not limited to:

a. third-party administrators as provided for in Sections

1441 through 1452 of Title 36 of the Oklahoma

Statutes,

b. health maintenance organizations as provided for in

Sections 6901 through 6936 of Title 36 of the Oklahoma

Statutes,

c. self-insured employer welfare arrangements,

d. excess carriers,

e. stop loss carriers,

f. multiple employer welfare arrangements (MEWA) as

provided for in Sections 633 through 650 of Title 36

of the Oklahoma Statutes,

g. professional employer organizations (PEO), and

h. the Oklahoma State and Education Employees Group

Insurance Board (OSEEGIB); and

6. “Insurance Commissioner” or “Commissioner” means the

Oklahoma Insurance Commissioner.
Okla. Stat. tit. 36, § 36-2107 — OK Code / Title 36 / Section 36-2107
Filing of articles; issuance of certificate
Status: in_force

A. The articles of incorporation shall be filed in the office

of the Secretary of State, and certified copies thereof shall be

filed with the Insurance Commissioner. Articles of incorporation

shall be approved by the Insurance Commissioner before they are

filed in the office of the Secretary of State. After January 1,

1970, the Insurance Commissioner shall not approve or renew any

articles of incorporation which provide for the issuance of shares

of common capital stock to any shareholder unless such shareholder

shall be entitled at the shareholders meetings to one vote for each

share standing in the name of such shareholder in the books of the

corporation.

B. Upon completion of such filing as to the articles of

incorporation, the Secretary of State shall issue to the corporation

a certificate of incorporation. Such corporation shall not transact

business as an insurer until it has applied for and received from

the Commissioner a certificate of authority as provided by this

Code.
Okla. Stat. tit. 36, § 36-1258 — OK Code / Title 36 / Section 36-1258
Renumbered as § 1250.14 of this title by Laws 1994, c
Status: in_force

342, § 20, eff. Sept. 1, 1994.
Okla. Stat. tit. 36, § 36-1107 — OK Code / Title 36 / Section 36-1107
Multistate risk - Required application and informational
Status: in_force

filings - Fee payments.

A. After procuring any surplus line insurance where Oklahoma is

the home state and the insurance involves a multistate risk, the

surplus lines licensee and broker shall submit such information

relating to the transaction as may be established by the Insurance

Commissioner. The data shall be provided to the Insurance

Commissioner until and unless in the exercise of his or her sole

discretion and judgment, the Insurance Commissioner decides to enter

or join the Nonadmitted Insurance Multi-State Agreement or any other

multistate agreement or compact with the same function and purpose

and other reporting requirements are thereby established.

B. When Oklahoma is the home state of the insured, the surplus

lines licensee or broker shall make all informational and tax

filings and fee and tax payments electronically in the manner and

form required or to be established by the Insurance Commissioner,

Oklahoma Statutes - Title 36. Insurance Page 253

along with any applicable transaction fees. When Oklahoma is the

home state of the insured, the premium tax filings and premium tax

payments shall be provided entirely to the Insurance Commissioner

until and unless, in the exercise of his or her sole discretion and

judgment, the Insurance Commissioner decides to enter or join the

Nonadmitted Insurance Multi-State Agreement or any other multistate

agreement or compact with the same function and purpose.

C. Failure to file the required information, any required fee

payments and make the required premium tax payments in the manner

established by the Insurance Commissioner pursuant to this section

and Section 1115 of this title where Oklahoma is the home state of

the insured shall result, after notice and hearing, in censure,

suspension, or revocation of license or a fine of up to Five Hundred

Dollars ($500.00) for each occurrence or by both such fine and

licensure penalty.
Okla. Stat. tit. 36, § 36-1806 — OK Code / Title 36 / Section 36-1806
Limitation on appointments
Status: in_force

A. The Insurance Commissioner is hereby prohibited from

appointing as supervisor or conservator during any period of

supervision or conservatorship:

1. Any current or former officer, director, or employee of the

insurer; and

Oklahoma Statutes - Title 36. Insurance Page 528

2. Any person who is related to the Commissioner within the

third degree of consanguinity or affinity.

B. The Commissioner is hereby prohibited from appointing as

attorney for the insurer during any period of supervision or

conservatorship:

1. Any current or former officer, director, or employee of the

insurer; and

2. Any person who is related to the Commissioner within the

third degree of consanguinity or affinity.
Okla. Stat. tit. 36, § 36-2714.1 — OK Code / Title 36 / Section 36-2714.1
Consolidations and mergers
Status: in_force

A. A domestic society may consolidate or merge with any other

society by complying with the provisions of this section. It shall

file with the Insurance Commissioner:

1. A certified copy of the written contract containing in full

the terms and conditions of the consolidation or merger;

2. A sworn statement by the president and secretary or

corresponding officers of each society showing the financial

condition thereof on a date fixed by the Commissioner but not

earlier than December 31 next preceding the date of the contract;

3. A certificate of such officers, duly verified by their

respective oaths, that the consolidation or merger has been approved

by a two-thirds (2/3) vote of the supreme governing body of each

society, such vote being conducted at a regular or special meeting

of each such body, or, if the society's laws so permit, by mail; and

4. Evidence that at least sixty (60) days prior to the action

of the supreme governing body of each society, the text of the

contract has been furnished to all members of each society either by

mail or by publication in full in the official publication of each

society.

B. If the Commissioner finds that the contract is in conformity

with the provisions of this section, that the financial statements

are correct and that the consolidation or merger is just and

equitable to the members of each society, the Commissioner shall

approve the contract and issue a certificate to such effect. Upon

approval, the contract shall be in full force and effect unless any

society which is a party to the contract is incorporated under the

laws of any other state or territory. In such event the

consolidation or merger shall not become effective unless and until

it has been approved as provided by the laws of such state or

territory and a certificate of the approval is filed with the

Commissioner of this state or, if the laws of such state or

territory contain no such provision, then the consolidation or

merger shall not become effective unless and until it has been

approved by the Commissioner of such state or territory and a

Oklahoma Statutes - Title 36. Insurance Page 721

certificate of approval filed with the Commissioner of this state.

In case the contract is not approved it shall be inoperative, and

the fact of the submission and its contents shall not be disclosed

by the Commissioner.

C. Upon the consolidation or merger becoming effective as

herein provided, all the rights, franchises and interests of the

consolidated or merged societies in and to every species of

property, real, personal or mixed, and things in action thereunto

belonging shall be vested in the society resulting from or remaining

after the consolidation or merger without any other instrument,

except that conveyances of real property may be evidenced by proper

deeds, and the title to any real estate or interest therein, vested

under the laws of this state in any of the societies consolidated or

merged, shall not revert or be in any way impaired by reason of the

consolidation or merger, but shall vest absolutely in the society

resulting from or remaining after such consolidation or merger.

D. The affidavit of any officer of the society or of anyone

authorized by it to mail any notice or document, stating that such

notice or document has been duly addressed and mailed, shall be

prima facie evidence that such notice or document has been furnished

the addressees.
Okla. Stat. tit. 36, § 36-2687 — OK Code / Title 36 / Section 36-2687
Conflicting laws
Status: in_force

Nothing in this Article shall be construed to supersede the

provisions of Sections 328.1 through 328.52 of Title 59, Oklahoma

Statutes, or as the same may be hereafter amended. In the event of

the conflict of any of the provisions of this Article with any of

the above-cited sections, then such cited section shall take

precedence over this Article, and this Article shall be construed

accordingly.
Okla. Stat. tit. 36, § 36-1522 — OK Code / Title 36 / Section 36-1522
Definitions
Status: in_force

As used in this act:

1. "Adjusted RBC Report" means an RBC report which has been

adjusted by the Insurance Commissioner in accordance with subsection

D of Section 1523 of this title;

2. "Corrective order" means an order issued by the Commissioner

specifying corrective actions which the Commissioner has determined

are required;

Oklahoma Statutes - Title 36. Insurance Page 412

3. "Domestic insurer" means any insurance company domiciled in

this state;

4. "Foreign insurer" means any insurance company which has a

certificate of authority to do business in this state but is not

domiciled in this state;

5. "Life or health insurer" means any insurance company with a

certificate of authority to write life or health insurance, or a

licensed property and casualty insurer writing only accident and

health insurance;

6. "Negative trend" means, with respect to a life or health

insurer or a fraternal benefit society, negative trend over a period

of time, as determined in accordance with the "Trend Test

Calculation" included in the Life or Fraternal RBC Instructions;

7. "NAIC" means the National Association of Insurance

Commissioners;

8. "Property and casualty insurer" means any insurance company

with a certificate of authority to write property or casualty

insurance, and shall not include monoline mortgage guaranty

insurers, financial guaranty insurers, or title insurers;

9. "RBC" means risk-based capital;

10. "RBC Instructions" means the RBC Report including risk-

based capital instructions adopted by the NAIC, as adopted by the

Commissioner by rule, and any amendments thereto adopted by the

Commissioner by rule;

11. "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. "Company Action Level RBC" means, with respect to any

insurer, the product of 2.0 and its Authorized Control

Level RBC,

b. "Regulatory Action Level RBC" means the product of 1.5

and its Authorized Control Level RBC,

c. "Authorized Control Level RBC" means the number

determined under the risk-based capital formula in

accordance with RBC Instructions, and

d. "Mandatory Control Level RBC" means the product of

0.70 and the Authorized Control Level RBC;

12. "RBC Plan" means a comprehensive financial plan containing

the elements specified in subsection B of Section 1524 of this

title;

13. "Revised RBC Plan" means an RBC Plan which is rejected by

the Commissioner and which is revised by the insurer with or without

the Commissioner's recommendations;

14. "RBC Report" means the report required in Section 1523 of

this title; and

15. "Total adjusted capital" means the sum of:

Oklahoma Statutes - Title 36. Insurance Page 413

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 with the Commissioner, and

b. such other items, if any, as the RBC Instructions, as

adopted by rule by the Commissioner, may provide.
Okla. Stat. tit. 36, § 36-6214 — OK Code / Title 36 / Section 36-6214
Bond of public adjuster
Status: in_force

A. Prior to the issuance of a license as a public adjuster or

any renewal of the license, the applicant shall file with the

Commissioner a surety bond in favor of the people of the State of

Oklahoma, executed by a surety company authorized to do business in

the state, in the amount of Twenty-five Thousand Dollars

($25,000.00). The total aggregate liability on the bond may be

limited to the payment of Twenty-five Thousand Dollars ($25,000.00).

The bond shall be conditioned on the accounting by the adjuster to

any insured whose claim the adjuster is handling for monies or any

other settlement received in connection with the claim.

B. Any bond shall remain in force concurrently with the license

or until the surety is released from liability by the Commissioner,

or until canceled by the surety. Without prejudice to any liability

accrued prior to the cancellation, the surety may cancel a bond upon

thirty (30) days' advance notice in writing filed with the

Commissioner.

C. Effective December 1, 1983, such bond shall be required of

all public adjusters.
Okla. Stat. tit. 36, § 36-4055.3 — OK Code / Title 36 / Section 36-4055.3
License required - Application procedures - Renewal -
Status: in_force

Authority granted by license - Nonresidents - New or revised

information - Training.

A. 1. A person shall not operate as a viatical settlement

provider or viatical settlement broker without first obtaining a

license from the Insurance Commissioner of the state of residence of

the viator.

2. a. A life insurance producer who has been duly licensed

as a resident insurance producer with a life line of

authority in this state or his or her home state for

at least one (1) year and is licensed as a nonresident

producer in this state shall be deemed to meet the

licensing requirements of this section and shall be

permitted to operate as a viatical settlement broker.

b. Not later than thirty (30) days from the first day of

operating as a viatical settlement broker, the life

insurance producer shall notify the Commissioner that

he or she is acting as a viatical settlement broker on

a form prescribed by the Commissioner, and shall pay

any applicable fee to be determined by the

Commissioner. Notification shall include an

acknowledgement by the life insurance producer that he

or she will operate as a viatical settlement broker in

accordance with the Viatical Settlements Act of 2008.

c. The insurer that issued the policy being viaticated

shall not be responsible for any act or omission of a

viatical settlement broker or viatical settlement

provider arising out of or in connection with the

viatical settlement transaction, unless the insurer

receives compensation for the placement of a viatical

settlement contract from the viatical settlement

provider or viatical settlement broker in connection

with the viatical settlement contract.

3. A person licensed as an attorney, certified public

accountant or financial planner accredited by a nationally

recognized accreditation agency, who is retained to represent the

viator, whose compensation is not paid directly or indirectly by the

viatical settlement provider, may negotiate viatical settlement

contracts on behalf of the viator without having to obtain a license

as a viatical settlement broker.

B. Application for a viatical settlement provider or a viatical

settlement broker license shall be made to the Commissioner by the

Oklahoma Statutes - Title 36. Insurance Page 874

applicant on a form prescribed by the Commissioner. The application

shall be accompanied by a fee of Five Hundred Dollars ($500.00).

C. Licenses may be renewed from year to year on the anniversary

date upon payment of the annual renewal fees of Five Hundred Dollars

($500.00). Failure to pay the fees by the renewal date results in

expiration of the license.

D. The applicant shall provide information on forms required by

the Commissioner. The Commissioner shall have authority, at any

time, to require the applicant to fully disclose the identity of all

stockholders, partners, officers, members and employees, and the

Commissioner may, in the exercise of the Commissioner's discretion,

refuse to issue a license in the name of a legal entity if not

satisfied that any officer, employee, stockholder, partner or member

thereof who may materially influence the applicant's conduct meets

the standards of the Viatical Settlements Act of 2008.

E. A license issued to a legal entity authorizes all partners,

officers, members and designated employees to act as viatical

settlement providers, viatical settlement brokers as applicable,

under the license, and all those persons shall be named in the

application and any supplements to the application.

F. Upon the filing of an application and the payment of the

license fee, the Commissioner shall make an investigation of each

applicant and issue a license if the Commissioner finds that the

applicant:

1. If a viatical settlement provider, has provided a detailed

plan of operation;

2. Is competent and trustworthy and intends to act in good

faith in the capacity involved by the license applied for;Oklahoma Statutes - Title 36. Insurance Page 25the filing of an application and the payment of the

license fee, the Commissioner shall make an investigation of each

applicant and issue a license if the Commissioner finds that the

applicant:

1. If a viatical settlement provider, has provided a detailed

plan of operation;

2. Is competent and trustworthy and intends to act in good

faith in the capacity involved by the license applied for;

3. Has a good business reputation and has had experience,

training or education so as to be qualified in the business for

which the license is applied for;

4. a. If a viatical settlement provider, has demonstrated

evidence of financial responsibility in a format

prescribed by the Commissioner, through a surety bond

executed and issued by an insurer authorized to issue

surety bonds in this state, a policy of errors and

omissions insurance, or a deposit of cash,

certificates of deposit or securities or any

combination thereof in the amount of Fifty Thousand

Dollars ($50,000.00), or

b. If a viatical settlement broker, has demonstrated

evidence of financial responsibility in a format

prescribed by the Commissioner, through a surety bond

executed and issued by an insurer authorized to issue

surety bonds in this state, a policy of errors and

omissions insurance, or a deposit of cash,

certificates of deposit or securities or any

Oklahoma Statutes - Title 36. Insurance Page 875

combination thereof in the amount of Fifty Thousand

Dollars ($50,000.00), or

c. The Commissioner may ask for evidence of financial

responsibility at any time the Commissioner deems

necessary;

5. If a legal entity, provides a certificate of good standing

from the state of its domicile; and

6. If a viatical settlement provider or viatical settlement

broker, has provided an antifraud plan that meets the requirements

of subsection G of Section 13 of Enrolled Senate Bill No. 1980 of

the 2nd Session of the 51st Oklahoma Legislature.

G. The Commissioner shall not issue a license to a nonresident

applicant, unless a written designation of an agent for service of

process is filed and maintained with the Commissioner, or the

applicant has filed with the Commissioner the applicant's written

irrevocable consent that any action against the applicant may be

commenced against the applicant by service of process on the

Commissioner.

H. A viatical settlement provider, viatical settlement broker

or viatical settlement investment agent shall provide to the

Commissioner new or revised information about officers, ten percent

(10%) or more stockholders, partners, directors, members or

designated employees within thirty (30) days of the change.

I. An individual licensed as a viatical settlement broker shall

complete on a biennial basis eight (8) hours of training related to

viatical settlements and viatical settlement transactions, as

required by the Commissioner; provided, however, that a life

insurance producer who is operating as a viatical settlement broker

pursuant to paragraph 2 of subsection A of this section shall not be

subject to the requirements of this subsection. Any person failing

to meet the requirements of this subsection shall be subject to the

penalties imposed by the Commissioner.
Okla. Stat. tit. 36, § 36-4512 — OK Code / Title 36 / Section 36-4512
Insured employer health benefit plans - 20 or more
Status: in_force

employees.

A. This section applies to an insured employer health benefit

plan providing health insurance to employees of employers employing

twenty (20) or more full-time or full-time-equivalent employees.

B. An employer carrier, on written request from an insured

employer covered by that carrier, shall report to the employer

information from the twelve (12) months preceding the date of the

report regarding:

1. The total amount of charges submitted to the carrier for

persons covered under the employer health benefit plan;

2. The total amount of premium payments made by the

policyholder to the insured carrier;

3. The total amount of payments made by the carrier to health

care providers for persons covered under the plan, including the

total hospital charges, physician charges, and pharmaceutical

charges; and

4. For any claims for an individual paid in excess of Ten

Thousand Dollars ($10,000.00), information on claims paid, including

diagnostic evaluations.

C. An employer shall have to make a written request for

information. The employer may make one request per year prior to

the anniversary or renewal date. In addition, prior to the date of

a rate change, an employer may make additional written requests for

the information, provided the employer shall not make more than one

additional request in any one (1) year.

D. Except as otherwise provided in this subsection, an employer

carrier shall provide the information provided for in this section

not later than sixty (60) days before the anniversary or annual

renewal date, or thirty (30) days before the date of any rate change

action of the employer's benefit plan. Provided, if the carrier

receives the request from the employer less than sixty (60) days

before the anniversary or renewal date or less than thirty (30) days

before the date of a rate change, the carrier shall have sixty (60)

days from the date of receiving the request to provide the

information. Provided further, if the carrier requires the employer

to submit any changes to the benefit plan prior to the anniversary

or annual renewal date, the carrier shall provide the information

not later than sixty (60) days before the date the employer is

required to submit any changes.

E. An employer carrier shall not report any information

required under this section if the release of such information is

prohibited by federal law or regulation.

F. Claim information provided by an employer carrier under this

section shall be provided in the aggregate, without information

through which a specific individual covered by the health insurance

or evidence or coverage may be identified. Claim information shall

Oklahoma Statutes - Title 36. Insurance Page 992

include the total claims made, the total claims paid, the total plan

charges and the head count by coverage.

G. 1. If an employer carrier fails to provide the information

in the time required by subsection D of this section, the Insurance

Commissioner may, after notice and hearing, subject an insurer to a

civil penalty of One Hundred Dollars ($100.00) for each day that the

information is delinquent.

2. If an employer carrier has a risk-bearing contract with a

medical group, independent practice association (IPA), or management

services organization (MSO) that stipulates the delegation of claims

payment, and the carrier satisfies the Insurance Commissioner that

the medical group, IPA, or MSO has failed to provide the information

to the employer carrier in a sufficient time for the carrier to

comply with subsection D of this section, the Commissioner may waive

the penalty provided for in paragraph 1 of this subsection.

3. The civil penalty may be enforced in the same manner in

which civil judgments may be enforced, as provided in Section 312A

of this title. Such penalties shall be placed in the State

Insurance Commissioner Revolving Fund. Any person aggrieved by the

determination of the Insurance Commissioner may seek judicial review

pursuant to Section 320 of this title.

H. The Insurance Commissioner shall promulgate rules for the

implementation and administration of this section.

I. As used in this section, "employer carrier" means any entity

which provides health insurance in this state. For the purposes of

this section, employer carrier includes a licensed insurance

company, not-for-profit hospital service or medical indemnity

corporation, a fraternal benefit society, a health maintenance

organization, a multiple employer welfare arrangement or any other

entity providing a plan of health insurance or health benefits

subject to state insurance regulation.
Okla. Stat. tit. 36, § 36-2007 — OK Code / Title 36 / Section 36-2007
Powers and duties of Association
Status: in_force

A. The Oklahoma Property and Casualty Insurance Guaranty

Association shall:

1. Be obligated to pay the covered claims existing prior to the

determination of insolvency if the claims arise within thirty (30)

days after the determination of insolvency, or before the policy

expiration date if less than thirty (30) days after the

determination, or before the insured replaces the policy or causes

its cancellation, if the insured does so within thirty (30) days of

the determination. The obligation shall be satisfied by paying to

the claimant an amount as follows:

a. the full amount of a covered claim for benefits under

a workers' compensation insurance coverage,

b. an amount not exceeding Ten Thousand Dollars

($10,000.00) per policy for a covered claim for the

return of unearned premium,

c. an amount not exceeding One Hundred Fifty Thousand

Dollars ($150,000.00) per claimant for all other

covered claims except for claims relating to a

cybersecurity insurance policy, and

d. in no event shall the Association be obligated to pay

an amount in excess of Three Hundred Thousand Dollars

($300,000.00) for all first- and third-party claims

under a policy or endorsement providing, or that is

found to provide, cybersecurity insurance coverage and

arising out of or related to a single insured event,

regardless of the number of claims made or the number

of claimants.

In no event shall the Association be obligated to pay a claimant

an amount in excess of the obligation of the insolvent insurer under

the policy or coverage from which the claim arises or in excess of

the limits of the obligation of the Association existing on the date

on which the order of liquidation is filed with the court clerk;

2. Any obligation of the Association to defend an insured shall

cease upon the payment or tender by the Association of an amount

equal to the lesser of the covered claim obligation limit of the

Association or the applicable policy limit;

3. As payor of last resort, have all rights, duties and

obligations of the insolvent insurer as if the insurer had not

become insolvent including, but not limited to, the right to pursue

and retain salvage and subrogation recoverable on covered claim

obligations to the extent paid by the Association. The Association

Oklahoma Statutes - Title 36. Insurance Page 577

shall not be deemed the insolvent insurer for the purpose of

conferring jurisdiction;

4. Allocate claims paid and expenses incurred among the three

accounts set out in Section 2005 of this title separately, and

assess member insurers separately for each account amounts necessary

to pay the obligations of the Association under this section

subsequent to a member insurer becoming an insolvent insurer, the

expenses of handling covered claims subsequent to an insolvency, and

other expenses authorized by the Oklahoma Property and Casualty

Insurance Guaranty Association Act, Sections 2001 through 2020 of

this title and Sections 2020.1 and 2020.2 of this title. The

assessments of each member insurer shall be in the proportion that

the net direct written premiums of the member insurer for the

calendar year preceding the assessment on the kinds of insurance in

the account bear to the net direct written premiums of all

participating insurers for the calendar year preceding the

assessment on the kinds of insurance in the account. Each member

insurer shall be notified in writing of the assessment not later

than thirty (30) days before it is due. No member insurer may be

assessed in any year an amount greater than two percent (2%) of the

net direct written premiums of that member or one percent (1%) of

that surplus of the member insurer as regards policyholders for the

calendar year preceding the assessment on the kinds of insurance in

the account, whichever is less. If the maximum assessment, together

with the other assets of the Association, does not provide in any

one (1) year in any account an amount sufficient to make all

necessary payments from that account, the funds available may be

prorated and the unpaid portion shall be paid as soon thereafter as

funds become available. The Association shall pay claims in any

order which it deems reasonable, including the payment of claims as

the claims are received from the claimants or in groups or

categories of claims. The Association may exempt or defer, in whole

or in part, the assessment of any member insurer, if the assessment

would cause the financial statement of the member insurer to reflect

amounts of capital or surplus less than the minimum amounts required

for a certificate of authority by any jurisdiction in which the

member insurer is authorized to transact insurance. During the

period of deferment, no dividends shall be paid to shareholders or

policyholders. Deferred assessments shall be paid when the payments

will not reduce capital or surplus below required minimums. The

payments may be refunded to those companies receiving larger

assessments by virtue of the deferment, or, at the election of any

company credited against future assessments. Each member insurer

serving as a servicing facility may set off against any assessment

authorized payments made on covered claims and expenses incurred in

the payment of covered claims by a member insurer if they are

chargeable to the account for which the assessment is made;

Oklahoma Statutes - Title 36. Insurance Page 578

5. Investigate claims brought against the Association and

adjust, compromise, settle and pay covered claims to the extent of

the obligation of the Association and deny all other claims. The

Association shall pay claims in any order that it may deem

reasonable, including, but not limited to, the payment of claims as

they are received from claimants or in groups of categories of

claims. The Association shall have the right to select and to

direct legal counsel under liability insurance policies for the

defense of covered claims;

6. Notify claimants in this state as deemed necessary by the

Commissioner and upon the request of the Commissioner, to the extent

records are available to the Association. Notification may include,

but shall not be limited to, a legal posting on the website of the

Association;

7. a. Handle claims through employees or through one or more

insurers or other persons designated as servicing

facilities. Designation of a servicing facility is

subject to approval of the Commissioner, but such

designation may be declined by a member insurer.

b. The Association shall have the right to review and

contest as set forth in this paragraph, settlements,

releases, compromises, waivers and judgments to which

the insolvent insurer or its insureds were parties

prior to the entry of the order of liquidation. In an

action to enforce settlements, releases and judgments

to which the insolvent insurer or its insureds were

parties prior to the entry of the order of

liquidation, the Association shall have the right to

assert the following defenses:

(1) the Association shall not be bound by a

settlement, release, compromise or waiver

executed by an insured or the insurer, or any

judgment entered against the insured or the

insurer by consent or through a failure to

exhaust all appeals, if the settlement, release,

compromise waiver or judgment was:

(a) executed or entered within one hundred

twenty (120) days prior to the entry of an

order of liquidation, and the insured or the

insurer did not use reasonable care in

entering into the settlement, release,

compromise, waiver or judgment, or did not

pursue all reasonable appeals of an adverse

judgment, or

(b) executed by or taken against an insured or

the insurer based on default, fraud,

Oklahoma Statutes - Title 36. Insurance Page 579

collusion or the failure of the insurer to

defend,

(2) if a court of competent jurisdiction finds that

the Association is not bound by a settlement,

release, compromise, waiver or judgment for the

releases provided for in division (1) of

subparagraph b of this paragraph, the settlement,

release, compromise, waiver or judgment shall be

set aside and the Association shall be permitted

to defend any covered claim on the merits. The

settlement, release, compromise, waiver or

judgment shall not be considered as evidence of

liability in connection with any claim brought

against the Association or any other party

pursuant to the Oklahoma Property and Casualty

Insurance Guaranty Association Act, and

(3) the Association shall have the right to assert

any statutory defenses or rights of offset

against any settlement, release, compromise or

waiver executed by an insured or the insurer, or

any judgment taken against the insured or the

insurer.

c. As to any covered claims arising from a judgment under

any decision, verdict or finding based on the default

of the insolvent insurer or its failure to defend, the

Association, either on its own behalf or on behalf of

an insured, may apply to have the judgment, order,

decision, verdict or finding set aside by the same

court or administrator that entered the judgment,

claim, decision, verdict or finding and shall be

permitted to defend on the merits;

8. Reimburse each servicing facility for obligations of the

Association paid by the facility and for reasonable expenses

incurred by the facility while handling claims on behalf of the

Association and pay the other expenses of the Association authorized

by the Oklahoma Property and Casualty Insurance Guaranty Association

Act;

9. Have standing to appear before any court of this state which

has jurisdiction over an impaired or insolvent insurer for whom the

Association is or may become obligated pursuant to the provisions of

the Oklahoma Property and Casualty Insurance Guaranty Association

Act. Standing shall extend to all matters germane to the powers and

duties of the Association including, but not limited to, proposals

for rehabilitation, acquisition, merger, reinsuring, or guaranteeing

the covered policies of the impaired or insolvent insurer, and the

determination of covered policies and contractual obligations of the

impaired or insolvent insurer; and

Oklahoma Statutes - Title 36. Insurance Page 580

10. Notwithstanding any other provision of the Oklahoma

Property and Casualty Insurance Guaranty Association Act, an

insurance policy issued by a member insurer and later allocated,

transferred, assumed by or otherwise made the sole responsibility of

another insurer pursuant to any provision of law providing for the

division of an insurance company, or the statutory assumption or

transfer of designated policies under which there is no remaining

obligation to the transferring entity, shall be considered to have

been issued by a member insurer which is an insolvent insurer for

the purposes of this act in the event that the insurer to which the

policy has been allocated, transferred, assumed or otherwise made

the sole responsibility of is placed in liquidation. An insurance

policy that was issued by an insurer who is not a member insurer and

subsequently allocated, transferred, assumed by or otherwise made

the sole responsibility of a member insurer under any provision of

law providing for the division of an insurance company shall not be

considered to have been issued by a member insurer pursuant to this

act.

B. The Association may:

1. Employ or retain persons as are necessary to handle claims

and perform other duties of the Association;

2. Borrow funds necessary to effect the purposes of the

Oklahoma Property and Casualty Insurance Guaranty Association Act in

accordance with the plan of operation;

3. Sue or be sued;

4. Negotiate and become a party to contracts as are necessary

to carry out the purpose of the Oklahoma Property and Casualty

Insurance Guaranty Association Act;

5. Refund to member insurers in proportion to the contribution

of each member insurer that amount by which the assets of the

Association exceed its liabilities, if at the end of any calendar

year the board of directors finds that the assets of the Association

exceed the liabilities as estimated by the board of directors for

the coming year;

6. Lend monies to an insurer declared to be impaired by the

Commissioner. The Association, with approval of the Commissioner,

shall approve the amount, length and terms of the loan. "Impaired

Insurer" for purposes of this section shall mean an insurer

potentially unable to fulfill its contractual obligations, but shall

not mean an insolvent insurer;

7. Perform other acts as are necessary or proper to effectuate

the purpose of the Oklahoma Property and Casualty Insurance Guaranty

Association Act;

8. Intervene as a party in interest in any supervision,

conservation, liquidation, rehabilitation, impairment or

receivership in which policyholders' interests and interests of the

Association may be or are affected; and

Oklahoma Statutes - Title 36. Insurance Page 581

9. Be designated or may contract as a servicing facility for

any entity which may be recommended by the board of directors of the

Association and shall be approved by the Commissioner.
Okla. Stat. tit. 36, § 36-2691.5 — OK Code / Title 36 / Section 36-2691.5
Contracts; investments
Status: in_force

A. A certified corporation may contract with any other person

who is licensed and qualified for the purpose of providing

chiropractic services to or for the subscribers but no certified

corporation shall enter into an exclusive or preferential contract

with any person.

B. A certified corporation may contract with any other person

for the cooperative administration or underwriting with regard to

the performance of the obligations created upon it under the

contracts it issues to the subscribers and to participating

chiropractors.

C. A certified corporation may join with, contract with or

become a member of any organization of other chiropractic service or

indemnity corporations, to create, establish or maintain an agency,

group or entity to facilitate the providing of chiropractic services

for subscribers located within or outside the State of Oklahoma.

D. A certified corporation may join with, contract with or

serve in any capacity with any agency of the United States of

America, the State of Oklahoma or any county, city or town, in

connection with any program or undertaking sponsored by one or more

of the above.

E. A certified corporation may invest in such real and personal

property as is reasonably necessary to conduct its business. The

prudent-man test shall be applicable to all such investments.
Okla. Stat. tit. 36, § 36-4503 — OK Code / Title 36 / Section 36-4503
Direct payment of hospital, medical services
Status: in_force

Any group accident and health policy may provide that subject to

any written direction of the insured in the application or

otherwise, all or any portion of any indemnities provided by any

such policy on account of hospital, nursing, medical or surgical

services may, at the insurer's option, and unless the insured

requests otherwise not later than the time of filing proofs of such

loss, be paid directly to the hospital or person rendering such

services; but the policy may not require that the service be

rendered by a particular hospital or person. Payments so made shall

discharge the insurer's obligation with respect to the amount of

insurance so paid.
Okla. Stat. tit. 36, § 36-6125.1 — OK Code / Title 36 / Section 36-6125.1
Maximum amount of principal an organization may receive
Status: in_force

pursuant to insurance contract.

Oklahoma Statutes - Title 36. Insurance Page 1146

A. The maximum amount of principal which an organization may

legally receive from any one individual pursuant to a contract

establishing a fund for prepaid funeral benefits pursuant to

paragraph 2 of subsection B of Section 6125 of this title shall be

Twenty Thousand Dollars ($20,000.00).

B. The maximum allowable amount of principal for subsequent

years shall be increased annually by a percentage equal to the

previous year’s increase in the national Consumer Price Index (CPI).

The Insurance Commissioner shall determine the amount of the

increase, if any, on April 1 of each year.
Okla. Stat. tit. 36, § 36-1435.36 — OK Code / Title 36 / Section 36-1435.36
Certain information to be included on license - Term
Status: in_force

of license.

A. The name, mailing address of the licensee, expiration date,

the line or lines of insurance coverage by the license, and such

other information as the Commissioner deems proper for inclusion in

the license shall be indicated on the license.

B. All licenses issued pursuant to the provisions of the

Insurance Agents Licensing Act shall continue in force not longer

than twenty-four (24) months. The renewal dates for the licenses

may be staggered throughout the year by notifying licensees in

writing of the expiration and renewal date being assigned to the

licensees by the Commissioner and by making appropriate adjustment

in the biennial licensing fee.
Okla. Stat. tit. 36, § 36-6060.9a — OK Code / Title 36 / Section 36-6060.9a
Anti-cancer medication coverage
Status: in_force

A. 1. Any health benefit plan that provides coverage and

benefits for cancer treatment shall provide coverage of prescribed

orally administered anticancer medications on a basis no less

favorable than intravenously administered or injected cancer

medications.

2. Coverage of orally administered anticancer medication shall

not be subject to any prior authorization, dollar limit, copayment,

deductible, or other out-of-pocket expense that does not apply to

intravenously administered or injected cancer medication, regardless

of formulation or benefit category determination by the company

administering the health benefit plan.

3. A health benefit plan shall not reclassify or increase any

type of cost-sharing to the covered person for anticancer

medications in order to achieve compliance with this section. Any

change in health insurance coverage that otherwise increases an out-

of-pocket expense to anticancer medications shall also be applied to

the majority of comparable medical or pharmaceutical benefits

covered by the health benefit plan.

4. A health benefit plan that limits the total amount paid by a

covered person through all cost-sharing requirements to no more than

One Hundred Dollars ($100.00) per filled prescription for any orally

administered anticancer medication shall be considered in compliance

with this section. For purposes of this paragraph, "cost-sharing

requirements" shall include copayments, coinsurance, deductibles,

and any other amounts paid by the covered person for that

prescription.

B. As used in this section:

1. "Anticancer medications" means medications used to kill or

slow the growth of cancer cells;

2. "Covered person" means a policyholder, subscriber, enrollee,

or other individual enrolled in or insured by a health benefit plan

for health insurance coverage; and

3. "Health benefit plan" means any plan or arrangement as

defined in subsection C of Section 6060.4 of Title 36 of the

Oklahoma Statutes.
Okla. Stat. tit. 36, § 36-6060.9d — OK Code / Title 36 / Section 36-6060.9d
Prescription eyedrop refills
Status: in_force

A. Any health benefit plan issued or renewed on or after

November 1, 2017, that provides coverage for prescription eyedrops

shall not deny coverage for a refill of a prescription if:

1. For a thirty-day supply, the amount of time has passed after

which a patient should have used seventy percent (70%) of the dosage

units of the drug according to a practitioner's instructions, or

twenty-one (21) days from:

a. the original date the prescription was distributed to

the insured, or

b. the date the most recent refill was distributed to the

insured;

2. The prescribing practitioner indicates on the original

prescription that additional quantities are needed;

3. The refill requested by the insured does not exceed the

number of additional quantities needed; and

4. The prescription eyedrops prescribed by the practitioner are

a covered benefit under the policy or contract to the insured.

B. As used in this section, "health benefit plan" means any

plan or arrangement as defined in subsection C of Section 6060.4 of

Title 36 of the Oklahoma Statutes.
Okla. Stat. tit. 36, § 36-7106 — OK Code / Title 36 / Section 36-7106
Permit required — Annual fee and report — Examination of
Status: in_force

books and records.

A. No owner of a cemetery shall maintain a Perpetual Care Trust

Fund, or certificate of deposit in lieu of a Perpetual Care Trust

Fund, unless the owner has received a permit from the Insurance

Commissioner. Initial and renewal permit applications shall be

filed electronically in the manner and form prescribed by the

Commissioner, along with a two-hundred-dollar application fee and

any transaction or other applicable fees. The permit shall expire

on March 15 of each calendar year unless it is renewed by the permit

holder. A permit expired for failure to submit a renewal

application and fee may be reinstated within ninety (90) days after

the expiration date by electronically filing a renewal application,

paying a fee in an amount that is double the renewal fee, and paying

any transaction or other applicable fees in the form and manner

prescribed by the Commissioner. The Commissioner shall require a

permit holder whose permit has been expired for more than ninety

(90) days to reapply as if a new applicant and pay an application

fee equal to an amount that is double the renewal fee, in addition

to any other fines imposed. Any application received after the

permit has been expired for more than ninety (90) days shall include

a detailed report of Perpetual Care Trust Fund services provided in

this state during the period that the permit was expired.

Oklahoma Statutes - Title 36. Insurance Page 1484

B. The owner of a cemetery maintaining a Perpetual Care Trust

Fund or certificate of deposit in lieu of a Perpetual Care Trust

Fund shall, by March 15 of each calendar year, electronically file a

report and pay any applicable fees in the manner and form prescribed

by the Commissioner. Such report shall show, for the preceding

calendar year:

1. The gross amount received from sales of grave spaces, lots,

mausoleum crypts and niches;

2. The total purchase price of grave spaces, lots, mausoleum

crypts and niches on contracts which received final payment and

required deposits to the Perpetual Care Fund during the calendar

year;

3. The operating expenses incurred during the calendar year

which are eligible to be paid from income of the Perpetual Care

Fund;

4. The total amount of the principal of the Perpetual Care Fund

as of the beginning of the preceding calendar year; and

5. The amount segregated and deposited in the Perpetual Care

Fund as provided by the Perpetual Care Fund Act which, if the

Perpetual Care Fund is held in trust, shall be certified by the

trustee of the Perpetual Care Fund as to correctness thereof, and

the trustee shall provide:

a. the total amount of the principal of the Perpetual

Care Fund as of the end of the calendar year,

b. the securities and other assets in which such

perpetual care funds are invested,

c. the cash on hand,

d. a verification in writing of all assets in which

monies of the Perpetual Care Fund have been invested;

provided, the verification shall be obtained from the

holder or holders of the assets,

e. the income derived from the Perpetual Care Fund

investments during the calendar year, and

f. the gross expenditures or transfers from income of the

Perpetual Care Fund during the calendar year.

The annual fee collected pursuant to this subsection shall be

deposited in the State Insurance Commissioner Revolving Fund created

pursuant to Section 307.3 of this title.

C. If the Perpetual Care Fund is maintained in a certificate of

deposit in lieu of a trust fund, the cemetery shall provide in its

annual report a verification from the financial institution as to

the amount of principal of the Perpetual Care Fund as of the end of

the calendar year, and the amount of funds contributed to the

certificate of deposit by the cemetery as of each maturity date of

the certificate of deposit during the last calendar year.

D. The Commissioner shall have authority, at any time, to

inspect the books and records of any cemetery, and to make an

Oklahoma Statutes - Title 36. Insurance Page 1485

examination thereof for the purpose of determining if proper sums

have been deposited with the trustee in the Perpetual Care Fund, or

in a certificate of deposit maintained in lieu of a trust fund, and

if the Fund is being properly administered by the trustee in

accordance with the provisions of the Perpetual Care Fund Act and

rules of the Commissioner. The examination shall be conducted

pursuant to Sections 309.1 through 309.7 of this title and the cost

of the examination shall be paid by the cemetery owner. The cost of

the examination shall be billed directly to the cemetery owner by

the examiner. Each cemetery owner and trustee is responsible for

maintaining satisfactory books and records which adequately justify

all information contained in the annual report required by this

section.

E. Whenever a cemetery owner and/or trustee refuses to submit

the books, records, papers, and instruments of the cemetery to the

examination and inspection of the assistants or examiners of the

Insurance Commissioner, or refuses or neglects to establish or

maintain a Perpetual Care Trust Fund in accordance with the

requirements of the Perpetual Care Fund Act within ninety (90) days

after a written demand to establish or maintain a Perpetual Care

Fund is made by the Commissioner, or in any manner obstructs or

interferes with the examination of its cemetery or refuses to be

examined on oath concerning any of the affairs of its cemetery, the

Commissioner may make application for receivership in the manner of

a domestic insurer pursuant to Sections 1901 through 1920 of this

title.
Okla. Stat. tit. 36, § 36-2733.1 — OK Code / Title 36 / Section 36-2733.1
Licensing of agents
Status: in_force

A. Agents of societies shall be licensed in accordance with the

provisions of Article 14A of the Insurance Code regulating the

licensing, revocation, suspension or termination of licenses of

resident and nonresident agents; provided, no examination shall be

required of any such agent licensed prior to the effective date of

this act.

B. No examination or license shall be required of any regular

salaried officer, employee or member of a licensed society who

devotes substantially all of his or her services to activities other

than the solicitation of fraternal insurance contracts from the

public, and who receives for the solicitation of such contracts no

commission or other compensation directly dependent upon the amount

of business obtained.

C. Any agent or representative of a society who devotes, or

intends to devote, less than fifty percent (50%) of his or her time

to solicitation and procurement of insurance contracts for the

society shall be exempt from the requirements of subsection A of

this section. Provided, however, any person who in the immediately

preceding calendar year solicited and procured life insurance

contracts on behalf of any society in an amount of insurance in

excess of Fifty Thousand Dollars ($50,000.00), or, in the case of

any other kinds of insurance which the society writes, on the

persons of more than twenty-five individuals, and who received or

will receive a commission or other compensation therefor, is

presumed to be devoting or intending to devote fifty percent (50%)

of his or her time to the solicitation or procurement of insurance

contracts for the society.
Okla. Stat. tit. 36, § 36-6202 — OK Code / Title 36 / Section 36-6202
Definitions
Status: in_force

As used in the Insurance Adjusters Licensing Act:

1. "Commissioner" means the Insurance Commissioner of the state

or his or her lawfully authorized representative;

2. "Adjuster" means either an insurance adjuster or a public

adjuster;

3. "Insurance adjuster" means any person, firm, association,

company, or legal entity that acts in this state for an insurer, and

that investigates claims, adjusts losses, negotiates claim

settlements, or performs incidental duties arising pursuant to the

provisions of insurance contracts on behalf of an insurer and

includes:

a. "independent adjusters", meaning any insurance

adjuster that suggests or presents to the insurance

industry and public that said adjuster acts as an

adjuster for a fee or other compensation, and

Oklahoma Statutes - Title 36. Insurance Page 1161

b. "company or staff adjusters", meaning adjusters who

engage in the investigation, adjustment, and

negotiation of claims as salaried employees of an

insurer;

4. "Public adjuster" means any person, firm, association,

company, or corporation that suggests or presents to members of the

public that said public adjuster represents the interests of an

insured or third party for a fee or compensation. Public adjusters

may investigate claims and negotiate losses to property only;

5. "Insurer" means any authorized insurance company,

corporation, reciprocal group, mutual group, underwriting

association or bureau, or any combination thereof, writing or

underwriting any insurance contracts;

6. “Home state” means the District of Columbia and any state or

territory of the United States in which the adjuster’s principal

place of residence or principal place of business is located. If

neither the state in which the adjuster maintains the principal

place of residence nor the state in which the adjuster maintains the

principal place of business has a licensing or examination

requirement, the adjuster may declare another state which has an

examination requirement and in which the adjuster is licensed to be

the “home state”; and

7. “Automated claims adjudication system” means a preprogrammed

computer system designed for the collection, data entry, calculation

and final resolution of consumer electronic products insurance

claims which:

a. may only be utilized by a licensed independent

adjuster, licensed agent, or individuals supervised by

a licensed independent adjuster or licensed agent,

b. shall comply with all claims payment requirements of

the Oklahoma Insurance Code, and

c. shall be certified as compliant by a licensed

independent adjuster.
Okla. Stat. tit. 36, § 36-1250.3 — OK Code / Title 36 / Section 36-1250.3
Application of law; conditions under which acts
Status: in_force

constitute unfair claims settlement practices.

A. The provisions of the Unfair Claims Settlement Practices Act

shall apply to all claims arising under an insurance policy or

insurance contract issued by any insurer.

B. It is an unfair claim settlement practice for any insurer to

commit any act set out in Section 1250.5 of this title, or to commit

a violation of any other provision of the Unfair Claims Settlement

Practices Act, if:

1. It is committed flagrantly and in conscious disregard of

this act or any rules promulgated hereunder; or

Oklahoma Statutes - Title 36. Insurance Page 307

2. It has been committed with such frequency as to indicate a

general business practice to engage in that type of conduct.
Okla. Stat. tit. 36, § 36-940 — OK Code / Title 36 / Section 36-940
Inquiry regarding making claim – Prohibited acts
Status: in_force

No insurer that issues any type of property or casualty

insurance policy in this state shall increase premium rates, cancel

a policy, or refuse to issue or renew a policy solely on the basis

of a policyholder inquiring about making a claim, if the

policyholder does not in fact submit a claim.
Okla. Stat. tit. 36, § 36-2042 — OK Code / Title 36 / Section 36-2042
Stay of other proceedings - Judgments may be set aside
Status: in_force

All proceedings in which the insolvent insurer is a party in any

court in this state shall be stayed one hundred eighty (180) days

from the date an order of liquidation, rehabilitation or

conservation is final to permit proper legal action by the Oklahoma

Life and Health Insurance Guaranty Association on any matters

germane to its powers or duties. As to judgment under any decision,

order, verdict or finding based on default, the Association may

apply to have the judgment set aside by the same court that made the

judgment and shall be permitted to defend against the suit on the

merits.
Okla. Stat. tit. 36, § 36-4055.12 — OK Code / Title 36 / Section 36-4055.12
Advertisement of contracts, products or services -
Status: in_force

Guidelines and standards.

A. The purpose of this section is to provide prospective

viators with clear and unambiguous statements in the advertisement

of viatical settlements and to assure the clear, truthful and

adequate disclosure of the benefits, risks, limitations and

exclusions of any viatical settlement contract. This purpose is

intended to be accomplished by the establishment of guidelines and

standards of permissible and impermissible conduct in the

advertising of viatical settlements to assure that product

descriptions are presented in a manner that prevents unfair,

deceptive or misleading advertising and is conducive to accurate

presentation and description of viatical settlements through the

advertising media and material used by viatical settlement

licensees.

Oklahoma Statutes - Title 36. Insurance Page 894

B. This section shall apply to any advertising of viatical

settlement contracts or related products or services intended for

dissemination in this state, including Internet advertising viewed

by persons located in this state. Where disclosure requirements are

established pursuant to federal regulation, this section shall be

interpreted so as to minimize or eliminate conflict with federal

regulation wherever possible.

C. Every viatical settlement licensee shall establish and at

all times maintain a system of control over the content, form and

method of dissemination of all advertisements of its contracts,

products and services. All advertisements, regardless of by whom

written, created, designed or presented, shall be the responsibility

of the viatical settlement licensees, as well as the individual who

created or presented the advertisement. A system of control shall

include regular routine notification, at least once a year, to

agents and others authorized by the viatical settlement licensee who

disseminate advertisements of the requirements and procedures for

approval prior to the use of any advertisements not furnished by the

viatical settlement licensee.

D. Advertisements shall be truthful and not misleading in fact

or by implication. The form and content of an advertisement of a

viatical settlement contract shall be sufficiently complete and

clear so as to avoid deception. It shall not have the capacity or

tendency to mislead or deceive. Whether an advertisement has the

capacity or tendency to mislead or deceive shall be determined by

the Insurance Commissioner from the overall impression that the

advertisement may be reasonably expected to create upon a person of

average education or intelligence within the segment of the public

to which it is directed.

E. The information required to be disclosed under this section

shall not be minimized, rendered obscure, or presented in an

ambiguous fashion or intermingled with the text of the advertisement

so as to be confusing or misleading.

1. An advertisement shall not omit material information or use

words, phrases, statements, references or illustrations if the

omission or use has the capacity, tendency or effect of misleading

or deceiving viators as to the nature or extent of any benefit, loss

covered, premium payable, or state or federal tax consequence. The

fact that the viatical settlement contract offered is made available

for inspection prior to consummation of the sale, or an offer is

made to refund the payment if the viator is not satisfied or that

the viatical settlement contract includes a “free look” period that

satisfies or exceeds legal requirements, does not remedy misleading

statements.

2. An advertisement shall not use the name or title of a life

insurance company or a life insurance policy unless the

advertisement has been approved by the insurer.

Oklahoma Statutes - Title 36. Insurance Page 895

3. An advertisement shall not state or imply that interest

charged on an accelerated death benefit or a policy loan is unfair,

inequitable or in any manner an incorrect or improper practice.

4. The words “free”, “no cost”, “without cost”, “no additional

cost”, “at no extra cost”, or words of similar import shall not be

used with respect to any benefit or service unless true. An

advertisement may specify the charge for a benefit or a service or

may state that a charge is included in the payment or use other

appropriate language.

5. Testimonials, appraisals or analysis used in advertisements

must be genuine; represent the current opinion of the author; be

applicable to the viatical settlement contract, product or service

advertised, if any; and be accurately reproduced with sufficient

completeness to avoid misleading or deceiving prospective viators as

to the nature or scope of the testimonials, appraisal, analysis or

endorsement. In using testimonials, appraisals or analysis, a

licensee under the Viatical Settlements Act of 2008 makes as its own

all the statements contained therein, and the statements are subject

to all the provisions of this section.

a. If the individual making a testimonial, appraisal,

analysis or an endorsement has a financial interest in

the party making use of the testimonial, appraisal,

analysis or endorsement, either directly or through a

related entity as a stockholder, director, officer,

employee or otherwise, or receives any benefit

directly or indirectly other than required union scale

wages, that fact shall be prominently disclosed in the

advertisement.

b. An advertisement shall not state or imply that a

viatical settlement contract, benefit or service has

been approved or endorsed by a group of individuals,

society, association or other organization unless that

is the fact and unless any relationship between an

organization and the viatical settlement licensee is

disclosed. If the entity making the endorsement or

testimonial is owned, controlled or managed by the

viatical settlement licensee, or receives any payment

or other consideration from the viatical settlement

licensee for making an endorsement or testimonial,

that fact shall be disclosed in the advertisement.

c. When an endorsement refers to benefits received under

a viatical settlement contract all pertinent

information shall be retained for a period of five (5)

years after its use.

F. An advertisement shall not contain statistical information

unless it accurately reflects recent and relevant facts. The source

of all statistics used in an advertisement shall be identified.

Oklahoma Statutes - Title 36. Insurance Page 896

G. An advertisement shall not disparage insurers, viatical

settlement providers, viatical settlement brokers, viatical

settlement investment agents, insurance producers, policies,

services or methods of marketing.

H. The name of the viatical settlement licensee shall be

clearly identified in all advertisements about the licensee or its

viatical settlement contract, products or services, and if any

specific viatical settlement contract is advertised, the viatical

settlement contract shall be identified either by form number or

some other appropriate description. If an application is part of

the advertisement, the name of the viatical settlement provider

shall be shown on the application.

I. An advertisement shall not use a trade name, group

designation, name of the parent company of a viatical settlement

licensee, name of a particular division of the viatical settlement

licensee, service mark, slogan, symbol or other device or reference

without disclosing the name of the viatical settlement licensee, if

the advertisement would have the capacity or tendency to mislead or

deceive as to the true identity of the viatical settlement licensee,

or to create the impression that a company other than the viatical

settlement licensee would have any responsibility for the financial

obligation under a viatical settlement contract.

J. An advertisement shall not use any combination of words,

symbols or physical materials that by their content, phraseology,

shape, color or other characteristics are so similar to a

combination of words, symbols or physical materials used by a

government program or agency or otherwise appear to be of such a

nature that they tend to mislead prospective viators into believing

that the solicitation is in some manner connected with a government

program or agency.

K. An advertisement may state that a viatical settlement

licensee is licensed in the state where the advertisement appears,

provided it does not exaggerate that fact or suggest or imply that

competing viatical settlement licensees may not be so licensed. The

advertisement may ask the audience to consult the licensee’s web

site or contact the department of insurance to find out if the state

requires licensing and, if so, whether the viatical settlement

provider, viatical settlement broker is licensed.

L. An advertisement shall not create the impression that the

viatical settlement provider, its financial condition or status, the

payment of its claims or the merits, desirability, or advisability

of its viatical settlement contracts are recommended or endorsed by

any government entity.

M. The name of the actual licensee shall be stated in all of

its advertisements. An advertisement shall not use a trade name,

any group designation, name of any affiliate or controlling entity

of the licensee, service mark, slogan, symbol or other device in a

Oklahoma Statutes - Title 36. Insurance Page 897

manner that would have the capacity or tendency to mislead or

deceive as to the true identity of the actual licensee or create the

false impression that an affiliate or controlling entity would have

any responsibility for the financial obligation of the licensee.

N. An advertisement shall not directly or indirectly create the

impression that any division or agency of the state or of the

federal government endorses, approves or favors:

1. Any viatical settlement licensee or its business practices

or methods of operation;

2. The merits, desirability or advisability of any viatical

settlement contract;

3. Any viatical settlement contract; or

4. Any life insurance policy or life insurance company.

O. If the advertiser emphasizes the speed with which the

viatication will occur, the advertising must disclose the average

time frame from completed application to the date of offer and from

acceptance of the offer to receipt of the funds by the viator.

P. If the advertising emphasizes the dollar amounts available

to viators, the advertising shall disclose the average purchase

price as a percent of face value obtained by viators contracting

with the licensee during the past six (6) months.
Okla. Stat. tit. 36, § 36-2027 — OK Code / Title 36 / Section 36-2027
Procedural rules and amendments
Status: in_force

A. 1. The Oklahoma Life and Health Insurance Guaranty

Association shall submit to the Insurance Commissioner procedural

rules and any amendments thereto necessary or suitable to assure the

fair, reasonable and equitable administration of the Association.

The procedural rules and any amendments thereto shall become

effective upon approval in writing by the Commissioner.

2. If the Association fails to submit suitable procedural rules

within one hundred eighty (180) days following the effective date of

this act or if at any time thereafter the Association fails to

submit suitable amendments to the rules, the Commissioner shall,

after notice and hearing, adopt and promulgate such reasonable rules

as are necessary to effectuate the provisions of the Oklahoma Life

and Health Insurance Guaranty Association Act. Such rules shall

continue in force until modified by the Commissioner or superseded

by rules submitted by the Association and approved by the

Commissioner. All member insurers shall comply with the procedural

rules.

B. The procedural rules shall, in addition to requirements

enumerated elsewhere in the Oklahoma Life and Health Insurance

Guaranty Association Act:

1. Establish procedures for handling the assets of the

Association;

2. Establish regular places and times for meeting of the Board

of Directors;

3. Establish procedures for records to be kept of all financial

transactions of the Association, its agents, and the Board of

Directors;

4. Establish the procedures whereby selections for the Board of

Directors will be made and submitted to the Commissioner;

5. Establish any additional procedures for assessments under

Section 2030 of this title; and

6. Contain additional provisions necessary or proper for the

execution of the powers and duties of the Association.

Oklahoma Statutes - Title 36. Insurance Page 602

C. The procedural rules may provide that any or all powers and

duties of the Association, except those under Section 2030 of this

title, are delegated to a corporation, association or other

organization which performs or will perform functions similar to

those of this Association, or its equivalent, in two or more states

if there is a reciprocal agreement with such states to provide

similar services. Such a corporation, association or organization

shall be reimbursed for any payments made on behalf of the

Association and shall be paid for the performance of any function of

the Association. A delegation of powers or duties under this

subsection shall take effect only with the approval of both the

Board and the Commissioner, and may be made only to a corporation,

association or organization which extends protection not

substantially less favorable and effective than that provided by

this act.
Okla. Stat. tit. 36, § 36-6412 — OK Code / Title 36 / Section 36-6412
Market Assistance Association - Creation
Status: in_force

There is hereby created a Market Assistance Association to

assist in the placement of homeowners' and liability insurance

coverage for residents of this state.

The Market Assistance Association is not a carrier capable of

assuming insurance risks. While it is believed that the Association

will be able to solve or at least reduce problems of availability,

it has no power to guarantee successful conclusion of all assistance

efforts and it is assumed that some risks may not be entitled to

coverage.
Okla. Stat. tit. 36, § 36-6916 — OK Code / Title 36 / Section 36-6916
Premium rates - Approval by Insurance Commissioner
Status: in_force

A. No premium rate may be used by a health maintenance

organization until such time as a schedule of premium rates or

methodology for determining premium rates has been filed with and

approved by the Insurance Commissioner. Such premium rates shall be

confidential and not subject to public disclosure.

B. Either a specific schedule of premium rates or a methodology

for determining premium rates shall be established in accordance

with actuarial principles for various categories of enrollees;

Oklahoma Statutes - Title 36. Insurance Page 1401

provided, that the premium applicable to an enrollee shall not be

individually determined based on the status of the enrollee’s

health. Provided further, that the premium rates shall not be

excessive, inadequate, unfair or discriminatory. A certification by

a qualified actuary or other qualified person acceptable to the

Insurance Commissioner as to the appropriateness of the use of the

methodology, based on reasonable assumptions, shall accompany the

filing along with adequate supporting information.

C. The Insurance Commissioner shall approve the schedule of

premium rates or methodology for determining premium rates if the

requirements of subsection B of this section are met. If the

Insurance Commissioner disapproves the filing, the Insurance

Commissioner shall notify the health maintenance organization. In

the notice, the Insurance Commissioner shall specify the reasons for

disapproval. A hearing will be conducted within thirty (30) days

after a request in writing by the person filing. If the Insurance

Commissioner does not take action on the schedule or methodology

within thirty (30) days of the filing of the schedule or

methodology, it shall be deemed approved.

D. When contracting with educational entities within the

meaning of Section 1306 of Title 74 of the Oklahoma Statutes, in

setting health insurance premiums for active employees and for

retirees under sixty-five (65) years of age, health maintenance

organizations shall set the monthly premium for active employees at

a maximum of Ninety Dollars ($90.00) less than the monthly premium

for retirees under sixty-five (65) years of age.
Okla. Stat. tit. 36, § 36-6220 — OK Code / Title 36 / Section 36-6220
Suspension, revocation or refusal to renew license –
Status: in_force

Grounds - Civil penalties - Surrender of license - Reinstatement.

A. The Commissioner may censure, suspend, revoke, or refuse to

issue or renew a license pursuant to the Insurance Adjusters

Licensing Act, levy a civil penalty in accordance with subsection B

of this section, or any combination of actions for any of the

following causes:

1. Material misrepresentation or fraud in obtaining an

adjuster’s license;

2. Any cause for which original issuance of a license could

have been refused;

3. Misappropriation, conversion to the personal use of the

licensee, or illegal withholding of monies required to be held by

the licensee in a fiduciary capacity;

4. Material misrepresentation of the terms and effect of any

insurance contract, with intent to deceive, or engaging in, or

attempting to engage in, any fraudulent transaction with respect to

a claim or loss that the licensee or the trainee is adjusting and,

in the case of a public adjuster, misrepresentation of the services

offered or the fees or commission to be charged;

5. Conviction of or pleading guilty or nolo contendere to a

felony pursuant to the laws of this state, any other state, the

United States, or any foreign country;

6. If in the conduct of business affairs, the licensee or

trainee has shown himself to be, and is so deemed by the

Commissioner, incompetent, untrustworthy or a source of injury to

the public;

Oklahoma Statutes - Title 36. Insurance Page 1178

7. Refusal to comply with any lawful order of the Commissioner;

8. Violation of any provision of the Insurance Adjusters

Licensing Act;

9. Adjusting losses or negotiating claim settlements arising

pursuant to provisions of insurance contracts on behalf of an

insurer or insured without proper licensing from the Commissioner

and authority from the licensed insurer or the insured party;

10. Failing to respond to any inquiry (including electronic

communications) from the Department within thirty (30) calendar days

of receipt of such inquiry;

11. Forging another’s name to any document;

12. Improperly using notes or any other reference material to

complete an examination for an insurance license;

13. Having admitted or been found to have committed any

insurance unfair trade practice or insurance fraud;

14. Having an insurance adjuster license or its equivalent

denied, suspended, censured, placed on probation or revoked in any

other state, province, district or territory;

15. Failing to inform the Department, by any means acceptable

to the Department, of a change of address, change of legal name or

change of information submitted on the application within thirty

(30) days of the change; or

16. Providing services as a public adjuster, company adjuster

or independent adjuster on the same claim.

B. In addition to or in lieu of any applicable denial,

suspension, or revocation of a license, any person violating the

provisions of the Insurance Adjusters Licensing Act may be subject

to a civil fine of not more than One Thousand Dollars ($1,000.00)

for each violation. This fine may be enforced in the same manner in

which civil judgment may be enforced.

C. The Commissioner shall not reinstate a license to any person

whose license has been suspended, revoked, or refused renewal until

the Commissioner determines that the cause or causes for the

suspension, revocation, or nonrenewal of the license no longer

exist.

D. The Department shall retain the authority to enforce the

provisions of and impose any penalty or remedy authorized by this

title against any person who is under investigation for or charged

with a violation even if the person’s license or registration has

been surrendered or has lapsed by operation of law.

E. It shall be unlawful for any person, firm, association,

company or corporation to act as an adjuster without first obtaining

a license pursuant to the Insurance Adjusters Licensing Act. Any

person convicted of violating the provisions of this subsection

shall be guilty of a misdemeanor and shall be punished as set forth

in Section 10 of Title 21 of the Oklahoma Statutes. The restriction

set forth in this subsection shall apply regardless of whether the

Oklahoma Statutes - Title 36. Insurance Page 1179

person, firm, association, company or corporation has obtained power

of attorney from an insurance claimant or has entered into any other

agreement with an insurance claimant to act on the behalf of the

claimant.
Okla. Stat. tit. 36, § 36-1927.1 — OK Code / Title 36 / Section 36-1927.1
Priority of distribution of claims from insurer's
Status: in_force

estate.

A. The priority of distribution of claims from the insurer's

estate shall be in accordance with the order in which each class of

claims is set forth in this section. Before the members of the next

class receive any payment, every claim in each class shall be:

1. Paid in full; or

2. Protected by adequate funds retained for such payment.

Once such funds are approved by the court and paid or retained by

the liquidator, the insurer's estate shall have no further liability

to members of that class except to the extent of the retained funds

and any other undistributed funds. Payment of retained funds

pursuant to court order under this section extinguishes the

potential liability of the receiver to the United States or any

other governmental entity. No subclasses shall be established

within any class except as otherwise provided by law. No claim by a

shareholder, policyholder or other creditor shall be permitted to

circumvent the priority classes through the use of equitable

remedies. The order of distribution of claims shall be as provided

in subsection B of this section.

B. 1. Class 1. The reasonable costs and expenses of

administration expressly approved by the receiver, including but not

limited to the following:

a. the actual and necessary costs of preserving or

recovering the assets of the insurer,

Oklahoma Statutes - Title 36. Insurance Page 555

b. compensation for all authorized services rendered in

the conservation, rehabilitation or liquidation,

c. any necessary filing or recordation fees,

d. the fees and mileage payable to witnesses, including

experts, and other litigation costs and expenses,

e. authorized reasonable attorney fees and other

professional services rendered in the conservation,

rehabilitation or liquidation, and

f. any reasonable expenses that were incurred in

furtherance of activities that provided a material

economic benefit to the estate.

2. Class 2. The administrative expenses of guaranty

associations. For purposes of this section these expenses shall be

the reasonable expenses incurred by guaranty associations where the

expenses are not payments or expenses which are required to be

incurred as direct policy benefits in fulfillment of the terms of

the insurance contract or policy, and that are of the type and

nature that, but for the activities of the guaranty association

otherwise would have been incurred by the receiver, including but

not limited to evaluations of policy coverage, activities involved

in the adjustment and settlement of claims under policies, including

those of in-house or outside adjusters, and the reasonable expenses

incurred in connection with the arrangements for ongoing coverage

through transfer to other insurers, policy exchanges or maintaining

policies in force. The receiver may in his or her sole discretion

approve as an administrative expense under this section any other

reasonable expenses of the guaranty association if the receiver

finds:

a. the expenses are not expenses required to be paid or

incurred as direct policy benefits by the terms of the

policy, and

b. the expenses were incurred in furtherance of

activities that provided a material economic benefit

to the estate as a whole, irrespective of whether the

activities resulted in additional benefits to covered

claimants.

The court shall approve such expenses unless it finds the receiver

abused his or her discretion in approving the expenses. If the

receiver determines that any administrative expenses of a guaranty

association were not reasonable expenses, but were nevertheless paid

out of a statutory deposit or the proceeds of any bond or other

asset located in another state or foreign country, then the court

shall adjudge the Class 3 claims of that association to have been

paid to the extent of the amount of unreasonable expenses thus paid

from those assets.

If the receiver determines that the assets of the estate will be

sufficient to pay all Class 1 claims in full, Class 2 claims shall

Oklahoma Statutes - Title 36. Insurance Page 556

be paid, provided that the liquidator shall secure from each of the

associations receiving disbursements pursuant to this section an

agreement to return to the liquidator such disbursements, together

with investment income actually earned on such disbursements, as may

be required to pay Class 1 claims. No bond shall be required of any

such association.

3. Class 3. All claims under policies including claims of the

federal or any state or local government for losses incurred ("loss

claims") including third-party claims, claims for unearned premiums,

all claims of a guaranty association for payment of covered claims

or covered obligations of the insurer and all claims of a guaranty

association for reasonable expenses other than those included in

Class 2. All claims under life and health insurance and annuity

policies, whether for death proceeds, health benefits, annuity

proceeds, or investment values shall be treated as loss claims.

That portion of any loss, indemnification for which is provided by

other benefits or advantages recovered by the claimant, shall not be

included in this class, other than benefits or advantages recovered

or recoverable in discharge of familial obligation of support or by

way of succession at death or as proceeds of life insurance, or as

gratuities. No payment by an employer to his employee shall be

treated as a gratuity.

Notwithstanding the foregoing, the following claims shall be

excluded from Class 3 priority:

a. obligations of the insolvent insurer arising out of

reinsurance contracts,

b. obligations incurred after the expiration date of the

insurance policy or after the policy has been replaced

by the insured or canceled at the insured's request or

after the policy has been canceled as provided in this

act. Notwithstanding the provisions of this

paragraph, earned premium claims on policies, other

than reinsurance agreements, shall not be excluded,

c. obligations to insurers, insurance pools or

underwriting associations and their claims for

contribution, indemnity or subrogation, equitable or

otherwise,

d. any claim which is in excess of any applicable limits

provided in the insurance policy issued by the

insolvent insurer,

e. any amount accrued as punitive or exemplary damages

unless expressly covered under the terms of the

policy, and

f. tort claims of any kind against the insurer, and

claims against the insurer for bad faith or wrongful

settlement practices.

Oklahoma Statutes - Title 36. Insurance Page 557

4. Class 4. Claims of the federal government other than those

claims included in Class 3.

5. Class 5. Debts due employees for services, benefits,

contractual or otherwise due arising out of such reasonable

compensation to employees for services performed to the extent that

they do not exceed two (2) months of monetary compensation and

represent payment for services performed within six (6) months

before the filing of the petition for liquidation or, if

rehabilitation preceded liquidation, within one (1) year before the

filing of the petition for rehabilitation. Principal officers and

directors shall not be entitled to the benefit of this priority

except as otherwise approved by the liquidator and the court. This

priority shall be in lieu of any other similar priority which may be

authorized by law as to wages or compensation of employees.

6. Class 6. Claims of any person, including claims of state or

local governments, except those specifically classified elsewhere in

this section.

7. Class 7. Claims for commissions and service fees, and

claims of attorneys for fees and expenses owed them by a person for

services rendered in opposing a formal delinquency proceeding. In

order to prove the claim, the claimant must show that the insurer

which is the subject of the delinquency proceeding incurred such

fees and expenses based on its best knowledge, information and

belief, formed after reasonable inquiry indicating opposition was in

the best interests of the person, was well grounded in fact and was

warranted by existing law or a good-faith argument for the

extension, modification or reversal of existing law, and that

opposition was not pursued for any improper purpose, such as to

harass or to cause unnecessary delay or needless increase in the

cost of the litigation.

8. Class 8. Claims of any state or local government for a

penalty or forfeiture, but only to the extent of the pecuniary loss

sustained from the act, transaction or proceeding out of which the

penalty or forfeiture arose, with reasonable and actual costs

occasioned thereby. The remainder of such claims shall be postponed

to the class of claims under paragraph 9 of this subsection.

9. Class 9. Surplus or contribution notes or similar

obligations, premium refunds on assessable policies, interest on

claims of Classes 1 through 8 and any other claims specifically

subordinated to this class.

10. Class 10.

a. Claims of shareholders or other owners arising out of

their capacity as shareholders or other owners, or

arising in any other capacity or facts except as they

may be qualified in Class 3 or 4 above; provided,

however, that no shareholder, member or other owner

shall be entitled to, or receive, any distribution

Oklahoma Statutes - Title 36. Insurance Page 558

from the insolvent insurer's estate under this

paragraph, if:

(1) the intentional wrongdoing, fraud, gross

negligence, negligence or other act, failure to

act, transaction or proceeding of such

shareholder, member or owner, alone or in concert

with others, or of a director or officer of the

insolvent insurer, is found by a court of

competent jurisdiction or by the receiver in his

or her reasonable discretion, to have caused, or

to have been a contributing factor to, the

insolvency of the insolvent insurer,

(2) funds were collected from the shareholder, member

or other owner, either directly or through an

insurance carrier, fidelity bond issuer or other

entity, as a consequence of, or related to, a

claim made or brought by the receiver of said

insurer, or

(3) any of the funds available for distribution

consist of punitive damages recovered by the

receiver of said estate from any source based

upon any claim made or brought by the receiver.

In the event there is no eligible shareholder, member

or other owner entitled to distribution in accordance

with this paragraph, the remaining funds and other

property of the insolvent insurer's estate, if any,

shall be distributed to a fund established and held in

the name of, and for the use and benefit of, the

receiver, through the Oklahoma Receivership Office or

any similar entity established by the receiver, which

shall be used in the administration of other insurers

in rehabilitation or liquidation.

b. All funds distributed to the receiver under this

paragraph shall be utilized by the receiver's staff

engaged in the rehabilitation or liquidation of

insolvent insurance business companies for the

following purposes:

(1) the administration of liquidations of estates

which temporarily or permanently do not have the

financial capability to administer the

liquidation, including the prosecution of claims

of the receiver, or

(2) the prosecution of petitions to place insurers in

rehabilitation or liquidation.

In the event such funds are distributed to or for an

insolvent insurer, the receiver shall obtain from the

insurer a promissory note or other evidence of

Oklahoma Statutes - Title 36. Insurance Page 559

indebtedness, secured by collateral if possible, for

the amount distributed, which shall be treated as a

Class 1 expense under paragraph 1 of this subsection.

The receiver shall make good-faith efforts to collect

reimbursement of any such loans. No funds distributed

to the receiver under this paragraph shall be used to

pay claims other than Class 1 claims under paragraph 1

of this subsection. The funds are not funds of the

State of Oklahoma and are not funds of the Oklahoma

Insurance Department or any other agency of the State

of Oklahoma.

This paragraph shall apply to the administration of all receivership

estates open and ongoing as of November 1, 2014, and to all

receivership proceedings commenced after November 1, 2014.

C. If any claimant of this state, another state or foreign

country shall be entitled to or shall receive a dividend upon his or

her claim out of a statutory deposit or the proceeds of any bond or

other asset located in another state or foreign country, unless such

deposit or proceeds shall have been delivered to the domiciliary

liquidator, then the claimants shall not be entitled to any further

dividend from the receiver until and unless all other claimants of

the same class, irrespective of residence or place of the acts or

contracts upon which their claims are based, shall have received an

equal dividend upon their claims, and after such equalization, such

claimants shall be entitled to share in the distribution of further

dividends by the receiver, along with and like all other creditors

of the same class, wheresoever residing.

D. Upon the declaration of a dividend, the receiver shall apply

the amount of the dividend against any indebtedness owed to the

insurer by the person entitled to the dividend. There shall be no

claim allowed for any deductible charged by a guaranty association

or entity performing a similar function.

E. This section shall apply to pending and future claims in

existing delinquency proceedings as well as to claims in delinquency

proceedings arising after the effective date of this section.

F. If any provision of this section or the application thereof

to any person or circumstances is held invalid, such invalidity

shall not affect other provisions or application of this section to

the extent such other provisions or application can be given effect

without the invalid provision or application.
Okla. Stat. tit. 36, § 36-6511 — OK Code / Title 36 / Section 36-6511
Short title
Status: in_force

Sections 6511 through 6518 and Sections 5 through 15 of this act

shall be known and may be cited as the "Small Employer Health

Insurance Reform Act".

Oklahoma Statutes - Title 36. Insurance Page 1272
Okla. Stat. tit. 36, § 36-4033 — OK Code / Title 36 / Section 36-4033
Definitions
Status: in_force

As used in the Life Insurance and Annuity Policyholders

Protection Act:

1. "Replacement" means any transaction in which a new life

insurance policy or a new annuity policy is to be purchased, and it

is known or should be known by the proposing agent, or by the

proposing insurer if there is no agent, that an existing individual

life insurance policy or an annuity policy has been, or is to be

lapsed, surrendered, converted, become extended insurance, or that

the cash loan value, or any portion thereof, is used or contemplated

for use in the future with the purchase of a new insurance policy or

annuity policy.

2. "Notice" means a document completed by the applicant and the

agent or insurer prior to completing a new application for a life

insurance policy or annuity policy when an agent is involved or

delivered with the policy when no agent is involved, which provides

information regarding replacement transactions. The document shall

be in substantially the same format for all insurers.

3. "Statement" means a document to be signed by the agent or

the applicant or both the agent and the applicant, which notifies

the replaced insurer of the replacement.
Okla. Stat. tit. 36, § 36-1271 — OK Code / Title 36 / Section 36-1271
Short title — Oklahoma Motor Vehicle Consumer Protection
Status: in_force

Act.

Oklahoma Statutes - Title 36. Insurance Page 320

This act shall be known and may be cited as the “Oklahoma Motor

Vehicle Consumer Protection Act”.
Okla. Stat. tit. 36, § 36-6012 — OK Code / Title 36 / Section 36-6012
Participation in premium assistance program – Recognition
Status: in_force

of self-funded or self-insured health care plans.

The Insurance Department shall recognize self-funded or self-

insured health care plans for the exclusive purpose of participation

in the premium assistance program created under Section 1010.1 of

Title 56 of the Oklahoma Statutes if such plans meet the

requirements under subsection J of Section 1010.1 of Title 56 of the

Oklahoma Statutes. A self-funded or self-insured health care plan

recognized by the Department under this section shall only be

considered a health care plan for the exclusive purposes of the

premium assistance program created under Section 1010.1 of Title 56

of the Oklahoma Statutes.Oklahoma Statutes - Title 36. Insurance Page 29
Okla. Stat. tit. 36, § 36-1623 — OK Code / Title 36 / Section 36-1623
Purchase money mortgages
Status: in_force

An insurer may invest in purchase money mortgages or like

securities, received by it upon the sale or exchange of real

property theretofore owned by it. Provided, however, such

investments shall be subject to the limitations of Section 1622 of

this title.