reglab/housing_qa huggingface dataset:
NC Gen Stat § 58-47-160 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-160 - Written agreement; composition; restrictions.

 58-47-160. Written agreement; composition; restrictions.(a) No person may act as a TPA or service company without a written agreement between the TPA or service company and the self-insurer. The written agreement shall be retained by the self-insurer and the TPA or service company for the duration of the agreement and for five years thereafter. The agreement shall contain all provisions required by this Article, to the extent those requirements apply to the functions performed by the TPA or service company.(b) Groups shall file with the Commissioner the written agreement, and any amendments to the agreement, within 30 days after execution. Single employers shall furnish the Commissioner, upon request, the written agreement and any amendments to the agreement. The information required by this section, including any trade secrets, shall be kept confidential; provided that the Commissioner may use that information in any judicial or administrative proceeding instituted against the TPA or service company.(c) The written agreement shall set forth the duties and powers of the TPA or service company and the self-insurer. The Commissioner shall disapprove any such written agreement that:(1) Subjects the self-insurer to excessive charges for expenses or commission.(2) Vests in the TPA or service company any control over the management of the affairs of the self-insurer to the exclusion of the governing board of the self-insurer.(3) Is entered into with any TPA or service company if the person acting as the TPA or service company, or any of the officers or directors of the TPA or service company, is of known bad character or has been affiliated directly or indirectly through ownership, control, management, reinsurance transactions, or other insurance or business relationships with any person known to have been involved in the improper manipulation of assets, accounts, or reinsurance.(4) Is determined by the Commissioner to contain provisions that are not fair and reasonable to the self-insurer.(d) The self-insurer, TPA, or service company may, by written notice, terminate the agreement as provided in the agreement. The self-insurer may suspend the underwriting authority of the TPA during the pendency of any dispute regarding the cause for termination of the agreement. The self-insurer shall fulfill any lawful obligations with respect to policies affected by the agreement, regardless of any dispute between the self-insurer and the TPA or service company.(e) The contract may not be assigned in whole or part by the TPA or service company without prior approval by the governing board of the self-insurer and the Commissioner. (1997-362, s. 3.)
NC Gen Stat § 58-47-165 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-165 - Books and records.

 58-47-165. Books and records.(a) Every TPA or service company shall maintain and make available to the self-insurer complete books and records of all transactions performed on behalf of the self-insurer. The books and records shall be maintained by the self-insurer, TPA, or service company in accordance with G.S. 58-47-180.(b) The Commissioner shall have access to books and records maintained by a TPA or service company for the purposes of examination, audit, or inspection. The Commissioner shall keep confidential any trade secrets contained in those books and records, including the identity and addresses of the covered members of a self-insurer, except that the Commissioner may use the information in any judicial or administrative proceeding instituted against the TPA or service company.(c) The Commissioner may use the TPA or service company as an intermediary in the Commissioner's dealings with the self-insurer if the Commissioner determines that this will result in a more rapid and accurate flow of information from the self-insurer and will aid in the self-insurer's compliance with this Article and the Workers' Compensation Act.(d) The self-insurer shall own the books and records generated by the TPA or service company pertaining to the self-insurer's business.(e) The self-insurer shall have access to and rights to duplicate all books and records related to its business.(f) If the self-insurer and the TPA or service company cancel their agreement, notwithstanding the provisions of subsection (a) of this section, the TPA or service company, shall transfer all books and records to the new TPA, service company, or the self-insurer in a form acceptable to the Commissioner. The new TPA or service company shall acknowledge, in writing, that it is responsible for retaining the books and records of the previous TPA, service company, or the self-insurer as required in subsection (a) of this section. (1997-362, s. 3.)
NC Gen Stat § 58-47-170 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-170 - Payments to TPA or service company.

 58-47-170. Payments to TPA or service company.If a self-insurer uses the services of a TPA, the payment to the TPA of any premiums or charges for insurance by or on behalf of the insured party is considered payment to the self-insurer. The payment of return premiums or claim payments forwarded by the self-insurer to the TPA or service company is not considered payment to the insured party or claimant until the payments are received by the insured party or claimant. This section does not limit any right of the self-insurer against the TPA or service company resulting from the failure of the TPA or service company to make payments to the self-insurer, insured parties, or claimants. (1997-362, s. 3.)
NC Gen Stat § 58-47-175 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-175 - Approval of advertising.

 58-47-175. Approval of advertising.A TPA or service company may use only the advertising pertaining to or affecting the business underwritten by a self-insurer that has been approved in writing by the self-insurer before its use. (1997-362, s. 3.)
NC Gen Stat § 58-47-180 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-180 - Premium collection and payment of claims.

 58-47-180. Premium collection and payment of claims.(a) The TPA or service company, at a minimum, shall:(1) Periodically render an accounting to the self-insurer detailing all transactions performed by the TPA or service company pertaining to the business underwritten, premium or other charges collected, and claims paid by the self-insurer, when applicable.(2) Deposit all receipts directly into an account maintained in the name of the self-insurer.(3) Pay claims on drafts or checks of and authorized by the self-insurer.(4) Not withdraw from the self-insurer's account except for authority limited to pay claims and refund premiums.(5) Remit return premium, directly from the self-insurer's account, to the person entitled to the return premium.(b) Any check disbursement authority granted to the TPA or service company may be terminated upon the self-insurer's written notice to the TPA or service company or upon termination of the agreement. The self-insurer may suspend the check disbursement authority during the pendency of any dispute regarding the cause for termination. (1997-362, s. 3.)
NC Gen Stat § 58-47-185 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-185 - Notices; disclosure.

 58-47-185. Notices; disclosure.(a) When the services of a TPA are used, the TPA shall provide a written notice approved by the self-insurer to covered members advising them of the identity of, and relationship among, the TPA, the member, and the self-insurer.(b) When a TPA collects funds, the reason for collection of each item shall be identified to the member and each item shall be shown separately from any premium. Additional charges may not be made for services to the extent the services have been paid for by the self-insurer.(c) The TPA shall disclose to the self-insurer all charges, fees, and commissions received from all services in connection with the provision of administrative services for the self-insurer, including any fees or commissions paid by self-insurers for obtaining reinsurance.(d) The TPA or service company shall disclose to the self-insurer the nature of other business in which it is involved. (1997-362, s. 3.)
NC Gen Stat § 58-47-190 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-190 - Compensation.

 58-47-190. Compensation.A TPA or service company shall not enter into any agreement or understanding with a self-insurer that makes the amount of the TPA's or service company's commissions, fees, or charges contingent upon savings affected in the adjustment, settlement, and payment of losses covered by the self-insurer's obligations. This section does not prohibit a TPA or service company from receiving performance-based compensation for providing medical services through a physician-based network or auditing services and does not prevent the compensation of a TPA or service company from being based on premiums or charges collected or the number of claims paid or processed. (1997-362, s. 3.)
NC Gen Stat § 58-47-195 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-195 - Examinations.

 58-47-195. Examinations.TPAs and service companies may be examined under G.S. 58-2-131 through G.S. 58-2-134. (1997-362, s. 3; 1999-132, s. 11.8.)
NC Gen Stat § 58-47-200 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-200 - Unfair trade practices.

 58-47-200. Unfair trade practices.TPAs and service companies are subject to Article 63 of this Chapter. (1997-362, s. 3.)
NC Gen Stat § 58-47-205 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 47 - Workers' Compensation Self-Insurance.|§ 58-47-205 - Other requirements.

 58-47-205. Other requirements.(a) A TPA or service company, or any owner, officer, employee, or agent of a TPA or service company, or any other person affiliated with or related to the TPA or service company shall not:(1) Serve as a trustee of a self-insurer.(2) Make a contribution to the surplus of a self-insurer.(b) Each TPA or service company shall make available for inspection by the Commissioner copies of all contracts with persons using the services of the TPA.  (1997-362, s. 3; 2009-172, s. 4.)
NC Gen Stat § 58-48-1 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-1 - Short title.

 58-48-1. Short title.This Article shall be known and may be cited as the "Insurance Guaranty Association Act." (1971, c. 670, s. 1.)
NC Gen Stat § 58-48-5 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-5 - Purpose of Article.

 58-48-5. Purpose of Article. The purpose of this Article is to provide a mechanism for the payment of covered claims under certain insurance policies, to avoid excessive delay in payment, and to avoid financial loss to claimants or policyholders because of the insolvency of an insurer, to assist in the detection and prevention of insurer insolvencies, and to provide an association to assess the cost of such protection among insurers. (1971, c. 670, s. 1.)
NC Gen Stat § 58-48-10 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-10 - Scope.

 58-48-10. Scope.This Article shall apply to all kinds of direct insurance, but shall not be applicable to:(1) Life, annuity, accident and health or disability insurance;(2) Mortgage guaranty, financial guaranty or other forms of insurance offering protection against investment risks;(3) Fidelity or surety bonds, or any other bonding obligations;(4) Credit insurance, vendors' single interest insurance, collateral protection insurance, or any similar insurance protecting the interests of a creditor arising out of a creditor-debtor transaction;(5) Insurance of warranties or service contracts;(6) Title insurance;(7) Ocean marine insurance;(8) Repealed by Session Laws 1991 (Regular Session, 1992), c. 802, s. 1.(9) Any transaction or combination of transactions between a person (including affiliates of such person) and an insurer (including affiliates of such insurer) which involves the transfer of investment or credit risk unaccompanied by transfer of insurance risk;(10) Insurance written on a retroactive basis to cover known or unknown losses which have resulted from an event with respect to which a claim has already been made, and the claim is known to the insurer at the time the insurance is bound. (1971, c. 670, s. 1; 1989, c. 206, s. 1; 1991 (Reg. Sess., 1992), c. 802, s. 1.)
NC Gen Stat § 58-48-15 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-15 - Construction.

 58-48-15. Construction. This Article shall be liberally construed to effect the purpose under G.S. 58-48-5 which shall constitute an aid and guide to interpretation. (1971, c. 670, s. 1.)
NC Gen Stat § 58-48-25 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-25 - Creation of the Association.

 58-48-25. Creation of the Association.There is created a nonprofit, unincorporated legal entity to be known as the North Carolina Insurance Guaranty Association. All insurers defined as member insurers in G.S. 58-48-20(6) 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 G.S. 58-48-40 and shall exercise its powers through a board of directors established under G.S. 58-48-30. For purposes of administration and assessment, the Association shall be divided into three separate accounts: (i) the automobile insurance account; (ii) the workers' compensation account; and (iii) the account for all other insurance to which the Article applies. Each person becoming a member insurer after October 1, 1985, shall pay to the Association upon demand a nonrefundable initial membership fee of fifty dollars ($50.00). (1971, c. 670, s. 1; 1985, c. 613, s. 4; 1991 (Reg. Sess., 1992), c. 802, s. 3.)
NC Gen Stat § 58-48-30 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-30 - Board of directors.

 58-48-30. Board of directors. (a) The board of directors of the Association shall consist of not less than five nor more than nine persons serving terms as established in the plan of operation. One non-voting member of the board shall be a property and casualty insurance agent authorized to write insurance for a member insurer, and appointed by the Commissioner; and the remaining members shall be selected by member insurers subject to the approval of the Commissioner. Vacancies of the board shall be filled for the remaining period of the term in the same manner as initial appointments. If no members are selected within 60 days after June 25, 1971, the Commissioner may appoint the initial members of the board of directors.(b) In approving selections to the board, the Commissioner shall consider among other things whether all member insurers are fairly represented.(c) Members of the board may be reimbursed from the assets of the Association for expenses incurred by them as members of the board of directors. (1971, c. 670, s. 1; 1987, c. 864, s. 60.)
NC Gen Stat § 58-48-42 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-42 - Procedure for appeal to Commissioner from decision of Association.

 58-48-42. Procedure for appeal to Commissioner from decision of Association.In any hearing called by the Commissioner for an appeal made pursuant to G.S. 58-48-40(c)(7), no later than 20 days before the hearing the appellant shall file with the Commissioner or the Commissioner's designated hearing officer and shall serve on the appellee a written statement of the appellant's case and any evidence the appellant intends to offer at the hearing. No later than five days before the hearing, the appellee shall file with the Commissioner or the Commissioner's designated hearing officer and shall serve on the appellant a written statement of the appellee's case and any evidence the appellee intends to offer at the hearing. Each hearing shall be recorded and transcribed. The cost of the recording and transcribing shall be borne equally by the appellant and the appellee. However, upon any final adjudication the prevailing party shall be reimbursed for that party's share of the costs by the other party. Each party shall, on a date determined by the Commissioner or the Commissioner's designated hearing officer, but not sooner than 15 days after delivery of the completed transcript to the party, submit to the Commissioner or the Commissioner's designated hearing officer and serve on the other party, a proposed order. The Commissioner or the Commissioner's designated hearing officer shall then issue an order. (1991, c. 644, s. 31; 1993, c. 504, s. 42.)
NC Gen Stat § 58-48-45 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-45 - Duties and powers of the Commissioner.

 58-48-45. Duties and powers of the Commissioner.(a) The Commissioner shall:(1) Notify the Association of the existence of an insolvent insurer not later than three days after he receives notice of the determination of the insolvency.(2) Upon request of the board of directors, provide the Association with a statement of the net direct written premiums of each member insurer.(b) The Commissioner may:(1) Require that the Association notify the insureds of the insolvent insurer and any other interested parties of the determination of insolvency and of their rights under this Article. Such notification shall be by mail at their last known address, where available, but if sufficient information for notification by mail is not available, notice by publication in a newspaper of general circulation shall be sufficient.(2) Suspend or revoke, after notice and hearing, the license to transact insurance in this State of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the Commissioner may levy a fine on any member insurer which fails to pay an assessment when due. Such fine shall not exceed five percent (5%) of the unpaid assessment per month, except that no fine shall be less than one hundred dollars ($100.00) per month.(3) Revoke the designation of any servicing facility if he finds claims are being handled unsatisfactorily.(c) Any final action or order of the Commissioner under this Article shall be subject to judicial review in accordance with the provisions of G.S. 58-2-75. (1971, c. 670, s. 1; 1999-132, s. 9.1.)
NC Gen Stat § 58-48-50 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 48 - Postassessment Insurance Guaranty Association.|§ 58-48-50 - Effect of paid claims.

 58-48-50. Effect of paid claims.(a) Any person recovering under this Article shall be deemed to have assigned his rights under the policy or at law to the Association to the extent of his recovery from the Association. Every insured or claimant seeking the protection of this Article shall cooperate with the Association to the same extent as such person would have been required to cooperate with the insolvent insurer. The Association shall have no cause of action against the insured of the insolvent insurer for any sums it has paid out except such causes of action as the insolvent insurer would have had if such sums had been paid by the insolvent insurer. In the case of an insolvent insurer operating on a plan with assessment liability, payments of claims of the Association shall not operate to reduce the liability of insureds to the receiver, liquidator, or statutory successor for unpaid assessments.(a1) The Association shall have the right to recover from the following persons the amount of any "covered claim" paid and any and all expenses incurred, including attorneys' fees and costs of defense, in connection with any claim against the person or the person's affiliate pursuant to this Article:(1) Any insured whose net worth on December 31 of the year next preceding the date the insurer becomes insolvent exceeds fifty million dollars ($50,000,000) and whose liability obligations to other persons are satisfied in whole or in part by payments under this Article; or(2) Any person who is an affiliate of the insolvent insurer and whose liability obligations to other persons are satisfied in whole or in part by payments made under this Article.(b) The receiver, liquidator, or statutory successor of an insolvent insurer shall be bound by settlements of covered claims by the Association or a similar organization in another state. The court having jurisdiction shall grant such claims priority equal to that to which the claimant would have been entitled in the absence of this Article against the assets of the insolvent insurer. The expenses of the Association or similar organization in handling claims shall be accorded the same priority as the liquidator's expenses.(c) The Association shall periodically file with the receiver or liquidator of the insolvent insurer statements of the covered claims paid by the Association and estimates of anticipated claims on the Association which shall preserve the rights of the Association against the assets of the insolvent insurer. (1971, c. 670, s. 1; 1989, c. 206, ss. 4, 5; 2003-167, s. 2.)