reglab/housing_qa huggingface dataset:
TN Code § 56-6-406 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-406. Administrator's Duties as Fiduciary

 All insurance charges or premiums collected by an administrator on behalf of or for an insurer or insurers, and return premiums received from the insurer or insurers, shall be held by the administrator in a fiduciary capacity. The funds shall be immediately remitted to the person or persons entitled to the funds, or shall be deposited promptly in a fiduciary bank account established and maintained by the administrator. If charges or premiums so deposited have been collected on behalf of or for more than one (1) insurer, the administrator shall cause the bank in which the fiduciary account is maintained to keep records clearly recording the deposits in and withdrawal from the account on behalf of or for each insurer. The administrator shall promptly obtain and keep copies of all the records and, upon request of an insurer, shall furnish the insurer with copies of the records pertaining to deposits and withdrawals on behalf of or for the insurer. The administrator shall not pay any claim by withdrawals from the fiduciary account. Withdrawals from the account shall be made, as provided in the written agreement between the administrator and the insurer, for:   Remittance to an insurer entitled to the remittance;   Deposit in an account maintained in the name of the insurer;   Transfer to and deposit in a claims paying account, with claims to be paid as provided in § 56-6-407;   Payment to a group policyholder for remittance to the insured entitled to the remittance;   Payment to the administrator of its commission, fees or charges; or   Remittance of return premiums to the person or persons entitled to the remittance.
TN Code § 56-6-407 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-407. Payment of Claims

 All claims paid by the administrator from funds collected on behalf of the insurer shall be paid only on drafts, checks or electronic transfers of and as authorized by the insurer.
TN Code § 56-6-408 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-408. Administrator's Compensation Not Contingent on Claim Experience

  With respect to any policies where an administrator adjusts or settles claims, the compensation to the administrator with regard to the policies shall in no way be contingent on claim experience.   This section shall not prevent the compensation of an administrator from being based on premiums or charges collected or number of claims paid or processed.
TN Code § 56-6-409 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-409. Notice to Insured Persons — Notice to Persons Purchasing Coverage

  Where the services of an administrator are utilized, the administrator shall provide a written notice approved by the insurer, to insured individuals, advising them of the identity of and relationship among the administrator, the policyholder and the insurer.   Where an administrator collects funds, it must identify and state separately in writing to the person paying to the administrator any charge or premium for insurance coverage the amount of  the charge or premium specified by the insurer for the insurance coverage.
TN Code § 56-6-410 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-410. License Requirements

  No person shall act as, or hold out to be, an administrator in this state, other than an adjuster licensed in this state for the kinds of business for which the person is acting as an adjuster, unless the person holds a license as an administrator issued by the commissioner. Failure to hold the license shall subject the administrator to a fine of not less than one hundred dollars ($100) nor more than five hundred dollars ($500). The license shall be issued by the commissioner to an administrator unless the commissioner, after due notice and hearing, shall have determined that the administrator is not competent, trustworthy, financially responsible or of good personal and business reputation, or has had a previous application for an insurance license denied for cause within five (5) years.   All applications shall be accompanied by a fee of one hundred dollars ($100). The license is renewable annually on the date of issue. A request for renewal must be accompanied by a renewal fee of fifty dollars ($50.00). Prior to the issuance or renewal of the license of any administrator, a fidelity bond in a form and amount as determined by the commissioner shall be obtained by the licensee.   After notice and hearing, the commissioner may revoke the license or fine the administrator not more than five hundred dollars ($500), or both, or the commissioner may suspend the license, or fine the administrator not more than five hundred dollars ($500), or both, upon finding that either the administrator violated any of the requirements of §§ 56-6-402 and 56-6-404 — 56-6-409, or the administrator is not competent, trustworthy, financially responsible, or of good personal and business reputation.
TN Code § 56-6-411 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-411. Waiver of License Requirements

 The commissioner may waive the requirements of § 56-6-410 for any person or class of persons. The factors taken into account in granting the waiver shall include, but not be limited to:   Whether the person acting as an administrator is primarily in a business other than that of administrator;   Whether the financial strength or history of the organization indicates stability in its continuity of doing business; and   Whether the regular duties being performed as an administrator are such that the covered persons are not likely to be injured by a waiver of the requirements.
TN Code § 56-6-412 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 4 - Administrators|§ 56-6-412. Federally Regulated Trusts

 This part shall not be applicable to those trusts regulated by the federal government.
TN Code § 56-6-501 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-501. Short Title

 This part shall be known and may be cited as the “Managing General Agents Act.”
TN Code § 56-6-502 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-502. Part Definitions

 As used in this part, unless the context otherwise requires:   “Actuary” means a person who is a member in good standing of the American Academy of Actuaries;   “Insurer” means any person, firm, association or corporation duly licensed in this state as an insurance company pursuant to § 56-2-102;    “Managing general agent” or “MGA” means any person who:   Manages all or part of the insurance business of an insurer, including the management of a separate division, department, or underwriting office; and   Acts as an agent for such insurer, whether known as a MGA, manager, or other similar term, and who, with or without the authority, either separately or together with affiliates, produces, directly or indirectly, and underwrites an amount of gross direct written premium equal to or more than five percent (5%) of the policyholder surplus in any one (1) quarter or year, as reported in the last annual statement of the insurer, and, related to the business produced, either:        Adjusts or pays claims in excess of ten thousand dollars ($10,000) per claim; or   Negotiates reinsurance on behalf of the insurer;    Notwithstanding subdivision (3)(A), the following persons shall not be considered as MGAs for the purposes of this part:   An employee of the insurer;   A United States manager of the United States branch of an alien insurer;   An underwriting manager that, pursuant to contract, manages all the insurance operations of the insurer, is under common control with the insurer, subject to the Insurance Holding Company System Act of 1986, compiled in chapter 11 of this title, and whose compensation is not based on the volume of premiums written; and   The attorney-in-fact authorized by and acting for the subscribers of a reciprocal insurer or inter-insurance exchange under powers of attorney; and   “Underwrite” means the authority to accept or reject risk on behalf of the insurer.
TN Code § 56-6-503 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-503. Requirements for Acting in Capacity of an Mga — Bond — Errors and Omissions Policy

  No person shall act in the capacity of an MGA, with respect to risks located in this state for an insurer licensed in this state, unless the person is a licensed insurance agent in this state.   No person shall act in the capacity of an MGA representing an insurer domiciled in this state, with respect to risks located outside this state, unless the person is a licensed insurance agent in this state, which includes a nonresident license, pursuant to this part.   The commissioner may require a bond in an amount acceptable to the commissioner for the protection of the insurer.   The commissioner may require the MGA to maintain an errors and omissions policy.
TN Code § 56-6-505 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-505. Insurers Doing Business With an Mga — Requirements

  The insurer shall have on file an independent financial examination, in a form acceptable to the commissioner, of each MGA with which it has done business.   If an MGA establishes loss reserves, the insurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the MGA. This is in addition to any other required loss reserve certification.   The insurer shall periodically, at least semi-annually, conduct an on-site review of the underwriting and claims processing operations of the MGA.   Binding authority for all reinsurance contracts or participation in insurance or reinsurance syndicates shall rest with an officer of the insurer, who shall not be affiliated with the MGA.   Within thirty (30) days of entering into or termination of a contract with an MGA, the insurer shall provide written notification of the appointment or termination to the commissioner. Notices of appointment of an MGA shall include a statement of duties that the applicant is expected to perform on behalf of the insurer, the lines of insurance for which the applicant is to be authorized to act, and any other information the commissioner may request.    An insurer shall review its books and records each quarter to determine if any producer, as defined by § 56-6-602, has become, by operation of § 56-6-502(3), an MGA.   If the insurer determines that a producer has become an MGA pursuant to subdivision (f)(1), the insurer shall promptly notify the producer and the commissioner of that determination, and the insurer and producer must fully comply with this part within thirty (30) days.     An insurer shall not appoint to its board of directors an officer, director, employee, subproducer or controlling shareholder of its MGAs. This subsection (g) shall not apply to relationships governed by the Insurance Holding Company Act, compiled in chapter 11 of this title, or, if applicable, the Business Transacted with Producer Controlled Property/Casualty Insurer Act, compiled in part 6 of this chapter.
TN Code § 56-6-506 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-506. Acts of an Mga Considered Acts of the Insurer

 The acts of the MGA are considered to be the acts of the insurer on whose behalf it is acting. An MGA may be examined as if it were the insurer.
TN Code § 56-6-507 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-507. Violations of Provisions of Part — Penalties

  If the commissioner finds, after a hearing conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, that any person has violated this part, the commissioner may order:  For each separate violation, a penalty in an amount of five thousand dollars ($5,000);   Revocation or suspension of the producer's license; and   The MGA to reimburse the insurer, the rehabilitator or liquidator of the insurer for any losses incurred by the insurer caused by a violation of this part committed by the MGA.     The decision, determination or order of the commissioner pursuant to subsection (a) is subject to judicial review pursuant to the Uniform Administrative Procedures Act and state insurance law.   Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided for in the insurance law.   Nothing contained in this part is intended to or shall in any manner limit or restrict the rights of policyholders, claimants and auditors.
TN Code § 56-6-508 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-508. Commissioner — Authority to Promulgate Rules and Regulations

 The commissioner is authorized to promulgate rules and regulations to effectuate the purposes of this part. The rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
TN Code § 56-6-509 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-509. Commissioner — Waiver of Applicability of Chapter

 The commissioner may waive the application of this chapter to a particular person or arrangement if the application of this chapter is not necessary to carry out the purposes of this chapter.
TN Code § 56-6-510 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 5 - Managing General Agents Act|§ 56-6-510. Compliance With Part — When Required

 No insurer may continue to utilize the services of an MGA on and after July 1, 1991, unless the utilization is in compliance with this part.
TN Code § 56-6-601 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 6 - Business Transacted With Producer Controlled Property/casualty Insurer Act|§ 56-6-601. Short Title

 This part shall be known and may be cited as the “Business Transacted with Producer Controlled Property/Casualty Insurer Act.”
TN Code § 56-6-603 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 6 - Business Transacted With Producer Controlled Property/casualty Insurer Act|§ 56-6-603. Producer With Control of Licensed Property/casualty Insurer — Requirements

 No producer that has control of a licensed property/casualty insurer may directly or indirectly place business with the insurer in any transaction in which the producer, at the time the business is placed, is acting as such on behalf of the insured for any compensation, commission or other thing of value, unless:   There is a written contract between the controlling producer and the insurer, which contract has been approved by the board of directors of the insurer;   The producer, prior to the effective date of the policy, delivers written notice to the prospective insured disclosing the relationship between the producer and the controlled insurer. The disclosure, signed by the insured, shall be retained in the underwriting file until the filing of the report on examination covering the period in which the coverage is in effect. If the business is placed through a subproducer who is not a controlling producer, the controlling producer shall retain in the controlling producer's records a signed commitment from the subproducer that the subproducer is aware of the relationship between the insurer and the producer and that the subproducer has or will notify the insured;   All funds collected for the account of the insurer by the controlling producer must be paid, net of commissions, cancellations and other adjustments, to the insurer no less often than quarterly;   In addition to any other required loss reserve certification, the controlled insurer shall annually, on April 1 of each year, file with the commissioner an opinion of an independent casualty actuary, or other independent loss reserve specialist acceptable to the commissioner, reporting loss ratios for each line of business written and attesting to the adequacy of loss reserves established for losses incurred and outstanding as of year end, including incurred but not reported, on business placed by the producer;   The controlled insurer shall annually report to the commissioner the amount of commissions paid to the producer, the percentage the amount represents of the net premiums written and comparable amounts and percentage paid to noncontrolling producers for placements of the same kinds of insurance; and   Every controlled insurer shall have an audit committee of the board of directors composed of independent directors. Prior to approval of the annual financial statement, the audit committee shall meet with management, the insurer's independent certified public accountants, and an independent casualty actuary, or other independent loss reserve specialist acceptable to the commissioner, to review the adequacy of the insurer's loss reserves.
TN Code § 56-6-604 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 6 - Business Transacted With Producer Controlled Property/casualty Insurer Act|§ 56-6-604. Violations of Part — Hearing — Penalties

   If the commissioner believes that the controlling producer or any other person has not materially complied with this part, or any regulation or order promulgated under this part, after notice and opportunity to be heard, the commissioner may order the controlling producer to cease placing business with the controlled insurer; and   If it is found that, because of the material noncompliance, the controlled insurer or any policyholder of the insurer has suffered any loss or damage, the commissioner may institute a civil action or intervene in an action brought by or on behalf of the insurer or policyholder for recovery of compensatory damages for the benefit of the insurer or policyholder or other appropriate relief.     If an order for liquidation or rehabilitation of the controlled insurer has been entered pursuant to chapter 9, part 1 of this title, and the receiver appointed under that order believes that the controlling producer or any other person has not materially complied with this part, or any regulation or order promulgated under this part, and the insurer suffered any loss or damage from the noncompliance, the receiver may institute a civil action for recovery of damages or other appropriate sanctions for the benefit of the insurer.   Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided for in this title.   Nothing contained in this section is intended to or shall in any manner alter or affect the rights of policyholders, claimants, creditors or other third parties.
TN Code § 56-6-701 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 7 - Health Care Service Utilization Review Act|§ 56-6-701. Short Title

 This part shall be known and may be cited as the “Health Care Service Utilization Review Act.”
TN Code § 56-6-702 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 7 - Health Care Service Utilization Review Act|§ 56-6-702. Purpose

 The purpose of this part is to:   Promote the delivery of quality health care in a cost-effective manner;   Assure that utilization review agents adhere to reasonable standards for conducting utilization review;   Foster greater coordination and cooperation between health care providers and utilization review agents;   Improve communications and knowledge of benefit plan requirements among all parties concerned before expenses are incurred; and   Ensure that utilization review agents and procedures maintain and safeguard the confidentiality of all health-related records, especially mental health and chemical dependency disorders, in accordance with applicable laws and requirements of nationally recognized review accreditation bodies such as the Health Insurance Portability and Accountability Act (HIPAA) and the utilization review accreditation commission (URAC).
TN Code § 56-6-703 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 6 - Agents, Solicitors and Administrators|Part 7 - Health Care Service Utilization Review Act|§ 56-6-703. Part Definitions

 As used in this part, unless the context otherwise requires:   “Adverse determination” has the same meaning as defined in § 56-61-102;   “Clinical criteria” means the written policies, screening procedures, decision rules, decision abstracts, clinical protocols, practice guidelines, and medical protocols used by the utilization review agent to determine the necessity and appropriateness of health care services;   “Commissioner” means the commissioner of commerce and insurance;   “Enrollee” means an individual who has contracted for or who participates in coverage under an insurance policy, a health maintenance organization contract, a health service corporation contract, an employee welfare benefit plan, a hospital or medical services plan, or any other benefit program providing payment, reimbursement, or indemnification for health care costs for the individual or the individual's eligible dependents;   “Final adverse determination” has the same meaning as defined in § 56-61-102;   “Health care service” means health care procedures, treatments, or services provided by a facility licensed in this state or provided by a doctor of medicine, a doctor of osteopathy, or a health care professional licensed in this state;   “Medical necessity” has the same meaning as defined in § 56-61-102;   “Preauthorization” means the process by which the utilization review agent determines the medical necessity of otherwise covered health care services prior to the rendering of such health care services including, but not limited to, preadmission review, pretreatment review, utilization, and case management;   “Provider of record” means the physician or other licensed practitioner identified to the utilization review agent as having primary responsibility for the care, treatment, and services rendered to an individual;    “Utilization review” means a system for prospective and concurrent review of the necessity and appropriateness in the allocation of health care resources and services given or proposed to be given to an individual within this state;   “Utilization review” does not include elective requests for clarification of coverage; and     “Utilization review agent” means any person or entity, including the state, performing utilization review, except:  An agency of the federal government;   An agent acting on behalf of the federal government, but only to the extent that the agent is providing services to the federal government;   A hospital's internal quality assurance program;   An employee of a utilization review agent; or   Health maintenance organizations licensed and regulated by the commissioner, but only to the extent of providing utilization review to their own members.