reglab/statecodes huggingface dataset:
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 301.7 - Dental claim transparency.

Effective 5/5/2021
31A-26-301.7.
Dental claim transparency.
(1) As used in this section:
(a) "Bundling" means the practice of combining distinct dental procedures into one procedure for billing purposes.
(b) "Dental plan" means the same as that term is defined in Section 31A-22-646.
(c) "Downcoding" means the adjustment of a claim submitted to a dental plan to a less complex or lower cost procedure code.
(d) "Covered services" means the same as that term is defined in Section 31A-22-646.
(e) "Material change" means a change to:
(i) a dental plan's rules, guidelines, policies, or procedures concerning payment for dental services;
(ii) the general policies of the dental plan that affect a reimbursement paid to providers; or
(iii) the manner by which a dental plan adjudicates and pays a claim for services.
(2) An insurer that contracts or renews a contract with a dental provider shall:
(a) make a copy of the insurer's current dental plan policies available online; and
(b) if requested by a provider, send a copy of the policies to the provider through mail or electronic mail.
(3) Dental policies described in Subsection (2) shall include:
(a) a summary of all material changes made to a dental plan since the policies were last updated;
(b) the downcoding and bundling policies that the insurer reasonably expects to be applied to the dental provider or provider's services as a matter of policy; and
(c) a description of the dental plan's utilization review procedures, including:
(i) a procedure for an enrollee of the dental plan to obtain review of an adverse determination in accordance with Section 31A-22-629; and
(ii) a statement of a provider's rights and responsibilities regarding the procedures described in Subsection (3)(c)(i).
(4) An insurer may not maintain a dental plan that:
(a) based on the provider's contracted fee for covered services, uses downcoding in a manner that prevents a dental provider from collecting the fee for the actual service performed from either the plan or the patient; or
(b) uses bundling in a manner where a procedure code is labeled as nonbillable to the patient unless, under generally accepted practice standards, the procedure code is for a procedure that may be provided in conjunction with another procedure.
(5) An insurer shall ensure that an explanation of benefits for a dental plan includes the reason for any downcoding or bundling result.
Enacted by Chapter 288, 2021 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 302 - Settlement of claims in credit life and accident and health insurance.

31A-26-302.
Settlement of claims in credit life and accident and health insurance.
(1) The creditor shall promptly report all claims to the insurer or its designated claim representative. The insurer shall maintain adequate claims files. All claims shall be settled as soon as possible in accordance with the terms of the insurance contract.
(2) The insurer shall pay all claims either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of that claimant to another.
(3) A person other than the insurer or its designated claim representative may not settle or adjust claims. The creditor may not be designated as a claims representative.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 304 - Prohibition of conflicting roles.

31A-26-304.
Prohibition of conflicting roles.
A person licensed concurrently as both an independent and a public adjuster may not represent both the insurer and the insured in the same transaction.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 305 - Request for accepted check.

31A-26-305.
Request for accepted check.
If an insurance policy claimant entitled to receive money in settlement of a claim makes a timely request to the insurer for payment by accepted check, the insurer shall make payment to the claimant with a check accepted by the drawee under Sections 70A-3-410 through 70A-3-413.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 306 - Place of business -- Records.

31A-26-306.
Place of business -- Records.
(1)
(a) An insurance adjuster licensed under this chapter shall register and maintain with the commissioner:
(i) the address and telephone number of the licensee's principal place of business;
(ii) a valid business email address at which the commissioner may contact the licensee; and
(iii) if the licensee is an individual, the licensee's residence address and telephone number.
(b) A licensee shall notify the commissioner within 30 days of a change in one of the following required to be registered under Subsection (1)(a):
(i) an address;
(ii) a telephone number; or
(iii) a business email address.
(2) Except as provided under Subsection (3), an insurance adjuster shall keep at the address registered under Subsection (1), a record of the transactions consummated under the insurance adjuster's license, including a record of:
(a) each investigation or adjustment undertaken or consummated; and
(b) a fee, commission, or other compensation received or to be received by the adjuster on account of the investigation or adjustment.
(3) Subsection (2) is satisfied if the records specified in Subsection (2) can be obtained immediately from a central storage place elsewhere by on-line computer terminals located at the registered address.
(4)
(a) A record maintained as to a transaction under Subsection (2) shall be kept available for the inspection of the commissioner during all business hours for a period of time after the date of the transaction specified by the commissioner by rule, but in no case for less than the current calendar year plus three years.
(b) Discarding a record after the then applicable record retention period is passed does not place the licensee in violation of a later-adopted longer record retention period.
Amended by Chapter 284, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 307 - Claim reports to commissioner.

31A-26-307.
Claim reports to commissioner.
On the commissioner's request, any insurer or licensed adjuster connected with a loss or claim shall report to the commissioner all facts relative to the loss or claim arising under any insurance contract covering a subject of insurance that is resident, located, or to be performed in this state.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 308 - Settlement of liability insurance claim not admission of liability.

31A-26-308.
Settlement of liability insurance claim not admission of liability.
No settlement or partial settlement of a claim against any insured under a liability insurance policy is an admission, by either the insured or the insurer, of the liability of the insured on any claim arising from the same event or set of facts, whether the settlement is made by the insured, the insurer, or any other person on behalf of the insured or the insurer.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 309 - Adjuster's duty to report illegal insurance.

31A-26-309.
Adjuster's duty to report illegal insurance.
Section 31A-15-110 applies to the adjuster's duty to report illegal insurance.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 310 - Compensation of insurer's or insured's claims adjuster.

31A-26-310.
Compensation of insurer's or insured's claims adjuster.
(1)
(a) Except as provided in Subsection (2), an insurer or an insured may not pay a person who is representing the insurer or insured in connection with an insurance claim adjustment on any basis that is dependent, in whole or in part, upon the amounts paid an insured or claimant under an insurance policy.
(b) Subsection (1)(a) includes payments to:
(i) an employee of:
(A) the insurer; or
(B) the insured;
(ii) an independent contractor; or
(iii) a public adjuster.
(2) Subsection (1) does not prohibit a compensation arrangement:
(a) based upon the overall profitability of the insurer;
(b) based upon the discovery or proof of fraudulent insurance claims; or
(c) conforming to an order or rule of the commissioner that addresses the compensation of persons engaged in insurance adjusting on behalf of:
(i) an insurer; or
(ii) an insured.
Amended by Chapter 252, 2003 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 311 - Rescission of contracts with public adjusters.

31A-26-311.
Rescission of contracts with public adjusters.
(1) Except as provided in Subsection (2), an insured or claimant under an insurance policy who contracts with a public adjuster to assist in the settlement of a claim may rescind that contract by delivering written notice of rescission to the public adjuster within 10 days of entering into the contract.
(2) Subsection (1) does not apply if prior to the rescission the public adjuster has effected an acceptable settlement of the claim.
Enacted by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 3 - Claim Practices › Section 312 - Prohibited conduct.

Effective 5/9/2017
31A-26-312.
Prohibited conduct.
(1) An independent adjuster or public adjuster may not:
(a) participate directly or indirectly in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the independent adjuster or public adjuster;
(b) engage in any other activities that may reasonably be construed as presenting a conflict of interest, including soliciting or accepting remuneration from, or having a financial interest in, or deriving any direct or indirect financial benefit from, a salvage firm, repair firm, construction firm, or other firm that obtains business in connection with a claim that the independent adjuster or public adjuster has a contract or agreement to adjust;
(c) subject to Subsection (2), directly or indirectly solicit employment for an attorney or enter into a contract with an insured for the primary purpose of referring an insured to an attorney and without actually performing the services customarily provided by an independent adjuster or public adjuster;
(d) act on behalf of an attorney in having an insured sign an attorney representation agreement; or
(e) accept a fee, commission, or other valuable consideration of any nature, regardless of form or amount, in exchange for the referral by an independent adjuster or public adjuster of an insured to a third-party person, including an attorney, appraiser, umpire, construction company, contractor, repair firm, or salvage company.
(2) Subsection (1)(c) may not be construed to prohibit an independent adjuster or public adjuster from recommending a specific attorney to an insured.
(3) An independent adjuster or public adjuster who violates this section is subject to Section 31A-2-308.
Enacted by Chapter 168, 2017 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 4 - Public Adjusters › Section 401 - Required contracts.

Effective 5/9/2017
31A-26-401.
Required contracts.
(1) A public adjuster may not, directly or indirectly, act within this state as a public adjuster without having first entered into a contract, in writing, on a form filed with the department in accordance with Section 31A-21-201, executed in duplicate by the public adjuster and the insured or the insured's duly authorized representative. A public adjuster may not use a form of contract that is not filed with the department.
(2) A contract described in Subsection (1) is subject to recision in accordance with Section 31A-26-311.
(3)
(a) A contract described in Subsection (1) shall include a prominently displayed notice in 12-point boldface type that states "WE REPRESENT THE INSURED ONLY."
(b) The commissioner by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, may require additional prominently displayed notice requirements in the contract as the commissioner considers necessary.
(4) A public adjuster shall keep at the public adjuster's principal place of business a copy of each contract entered into in this state for the current year plus three years, and each contract shall be available at all times for inspection, without notice, by the commissioner or the commissioner's authorized representative.
(5) A public adjuster may not enter into a contract with an insured and collect compensation as provided in the contract without actually performing the services customarily provided by a licensed public adjuster for the insured.
Enacted by Chapter 168, 2017 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 4 - Public Adjusters › Section 402 - Compensation.

Effective 5/9/2017
31A-26-402.
Compensation.
(1) Except as provided by Subsection (2), a public adjuster may receive compensation for service provided under this chapter consisting of an hourly fee, a flat rate, a percentage of the total amount paid by an insurer to resolve a claim, or another method of compensation.
(2)
(a) A public adjuster may not receive a compensation consisting of a percentage of the total amount paid by an insurer to resolve a claim on a claim on which the insurer, not later than 72 hours after the date on which the loss is reported to the insurer, either pays or commits in writing to pay to the insured the policy limit of the insurance policy.
(b) A public adjuster is entitled to reasonable compensation from the insured for services provided by the public adjuster on behalf of the insured, based on the time spent on a claim that is subject to this Subsection (2) and expenses incurred by the public adjuster, until the claim is paid or the insured receives a written commitment to pay from the insurer.
(3) Except for the payment of compensation by the insured, a person paying proceeds of a policy of insurance or making a payment affecting an insured's rights under a policy of insurance shall:
(a) include the insured as a payee on the payment draft or check; and
(b) require the written signature and endorsement of the insured on the payment draft or check.
(4) A public adjuster may not accept any payment that violates this section notwithstanding whether the insured gives authorization to the public adjuster. A public adjuster may not sign and endorse any payment draft or check on behalf of an insured.
Enacted by Chapter 168, 2017 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 26 - Insurance Adjusters › Part 4 - Public Adjusters › Section 403 - Rulemaking.

Effective 5/9/2017
31A-26-403.
Rulemaking.
The commissioner may make rules, in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:
(1) addressing the forms required by this part;
(2) providing for notice requirements in contracts; and
(3) establishing the scope of a contract a public adjuster enters into with an insured that the public adjuster represents.
Enacted by Chapter 168, 2017 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27 - Delinquency Administrative Action Provisions › Part 5 - Administrative Actions › Section 501 - Title -- Construction -- Commissioner's powers.

31A-27-501.
Title -- Construction -- Commissioner's powers.
(1) This chapter is known as the "Delinquency Administrative Action Provisions."
(2) The proceedings authorized by this part may be applied to:
(a) all insurers and reinsurers:
(i) who are doing, or have done, an insurance business in this state; and
(ii) against whom claims arising from that business may exist;
(b) all insurers who have the appearance of or claim they do an insurance business in this state;
(c) all insurers who have insureds resident in this state; and
(d) all other persons organized or in the process of organizing to do an insurance business as an insurer in this state.
(3) This part shall be liberally construed to protect the interests of insureds, creditors, and the public generally, with minimum interference with the normal prerogatives of owners, through:
(a) early detection of any potentially dangerous condition in an insurer;
(b) prompt application of appropriate regulatory corrective measures; and
(c) regulation of the insurance business by law relating to insolvency of insurers and by substantive rules on the entire insurance business.
(4) This part does not limit the powers granted the commissioner by other provisions of law.
Renumbered and Amended by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27 - Delinquency Administrative Action Provisions › Part 5 - Administrative Actions › Section 504 - Conduct of hearings.

31A-27-504.
Conduct of hearings.
(1) The commissioner shall hold a hearing conducted under Section 31A-27-503 privately unless the insurer requests a public hearing.
(2) All records of the insurer, other documents, and all department files and papers, so far as they pertain to or are a part of the record of a hearing conducted under Section 31A-27-503, shall be kept confidential:
(a) except as is necessary to obtain compliance with a hearing conducted under Section 31A-27-503; or
(b) unless the insurer requests that the matter be made public.
(3) Any person having possession or custody of and refusing to deliver any of the records of an insurer against which an order is issued by the commissioner is in accordance with a hearing conducted under Section 31A-27-503 subject to Section 31A-2-308.
Renumbered and Amended by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 101 - Title -- Construction -- Commissioner's powers.

31A-27a-101.
Title -- Construction -- Commissioner's powers.
(1) This chapter is known as the "Insurer Receivership Act."
(2) The proceedings authorized by this chapter may be applied to:
(a) all insurers and reinsurers:
(i) who are doing, or have done, an insurance business in this state; and
(ii) against whom claims arising from that business may exist;
(b) all insurers who have the appearance of or claim they do an insurance business in this state;
(c) all insurers who have insureds resident in this state; and
(d) all other persons organized or in the process of organizing to do an insurance business as an insurer in this state.
(3) This chapter shall be liberally construed to protect the interests of insureds, claimants, creditors, and the public generally through:
(a) early detection of any potentially hazardous condition in an insurer;
(b) prompt application of appropriate corrective measures;
(c) the commissioner making rules pertaining to Subsections (3)(a) and (b):
(i) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and
(ii) that are similar to those set forth in the Model Regulation to Define Standards and Commissioner's Authority for Companies Deemed to be in Hazardous Financial Condition of the National Association of Insurance Commissioners;
(d) improved methods for conserving and rehabilitating insurers;
(e) enhanced efficiency and economy of liquidation, through clarification of the law, to minimize legal uncertainty and litigation;
(f) apportionment of any unavoidable loss in accordance with the statutory priorities set out in this chapter;
(g) lessening the problems of interstate receivership by:
(i) facilitating cooperation among states in delinquency proceedings; and
(ii) extending the scope of personal jurisdiction over debtors of the insurer outside this state;
(h) regulation of the business of insurance by the impact of the law relating to delinquency procedures and by substantive rules; and
(i) providing for a comprehensive scheme for the receivership of insurance companies and those subject to this chapter as part of the regulation of the business of insurance in this state.
(4) A proceeding in the case of insurer insolvency and delinquency are integral aspects of the business of insurance and are of vital public interest and concern.
(5) This chapter does not limit the powers granted the commissioner by other provisions of law.
(6) The powers and authority of a receiver under this chapter are:
(a) cumulative; and
(b) in addition to any power or authority available to a receiver under a law other than this chapter.
Amended by Chapter 253, 2012 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 103 - Insurer receivership laws.

31A-27a-103.
Insurer receivership laws.
(1) The state's insurer receivership laws consists of:
(a) this chapter; and
(b)Chapter 28, Guaranty Associations.
(2) The laws listed in Subsection (1) shall be construed together in a manner that is consistent.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 104 - Persons covered.

Effective 5/4/2022
31A-27a-104.
Persons covered.
(1) This chapter applies to:
(a) an insurer who:
(i) is doing, or has done, an insurance business in this state; and
(ii) against whom a claim arising from that business may exist;
(b) a person subject to examination by the commissioner;
(c) an insurer who purports to do an insurance business in this state;
(d) an insurer who has an insured who is resident in this state; and
(e) in addition to Subsections (1)(a) through (d), a person doing business as follows:
(i) under Chapter 6a, Service Contracts;
(ii) under Chapter 7, Nonprofit Health Service Insurance Corporations;
(iii) under Chapter 8a, Health Discount Program Consumer Protection Act;
(iv) under Chapter 9, Insurance Fraternals;
(v) under Chapter 11, Motor Clubs;
(vi) under Chapter 15, Unauthorized Insurers, Surplus Lines, and Risk Retention Groups;
(vii) as a bail bond surety company under Chapter 35, Bail Bond Act;
(viii) under Chapter 37, Captive Insurance Companies Act;
(ix) a title insurance company;
(x) a prepaid health care delivery plan; and
(xi) a person not described in Subsections (1)(e)(i) through (x) that is organized or doing insurance business, or in the process of organizing with the intent to do insurance business in this state.
(2) Notwithstanding Sections 31A-1-301 and 31A-27a-102, this chapter does not apply to a person licensed by the insurance commissioner as one or more of the following in this state unless the person engages in the business of insurance as an insurer, is an affiliate as defined in Subsection 31A-1-301(5), or is a person under the control of an affiliate:
(a) an insurance agency;
(b) an insurance producer;
(c) a limited line producer;
(d) an insurance consultant;
(e) a managing general agent;
(f) reinsurance intermediary;
(g) an individual title insurance producer or agency title insurance producer;
(h) a third party administrator;
(i) an insurance adjustor;
(j) a life settlement provider; or
(k) a life settlement producer.
Amended by Chapter 198, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 106 - Exemption from fees.

31A-27a-106.
Exemption from fees.
The receiver may not be required to pay any of the following fees to a public officer of this state:
(1) filing fees;
(2) recording fees;
(3) transcript fees;
(4) copying fees;
(5) certification fees; or
(6) authentication fees.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 109 - Statutes of limitations.

31A-27a-109.
Statutes of limitations.
(1) If applicable law, an order, or an agreement fixes a period within which the insurer may commence an action, and this period is not expired before the day on which the initial petition in a delinquency proceeding is filed, the receiver may not by reason of the filing of the initial petition in a delinquency proceeding be barred from commencing the action if the receiver commences the action on or before the later of:
(a) the end of the period, including any suspension of the period occurring on or after the day on which the initial petition in a delinquency proceeding is filed; or
(b) six years after the day on which the most recent receivership order is entered.
(2)
(a) Except as provided in Subsection (1), if applicable law, an order, or an agreement fixes a period within which the insurer may do an act described in Subsection (2)(b) and the period described in this Subsection (2)(a) is not expired before the date on which the initial petition in a delinquency proceeding is filed, the receiver may not by reason of the filing of the petition initiating a formal delinquency proceeding be barred from taking the act if the receiver does the act on or before the later of:
(i) the end of the period, including any suspension of the period occurring on or after the day on which the initial petition in a delinquency proceeding is filed; or
(ii) 60 days after the day on which the most recent receivership order is entered.
(b) This Subsection (2) applies to:
(i) filing, curing, or performing:
(A) a pleading;
(B) a demand;
(C) a notice; or
(D) a proof of claim or loss;
(ii) curing a default in a case or proceeding; or
(iii) performing any act similar to one described in Subsection (2)(b)(i) or (ii).
(3) If applicable law, an order, or an agreement fixes a period for commencing or continuing a civil action in a court other than the receivership court on a claim against the insurer, and the period has not expired before the day on which the initial petition in a delinquency proceeding is filed, the period does not expire until the later of:
(a) the end of the period, including any suspension of the period occurring on or after the day on which the initial petition in a delinquency proceeding is filed; or
(b) 30 days after the day on which the stay pursuant to this section with respect to the claim is terminated or expires.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 110 - Cooperation of officers, owners, and employees.

31A-27a-110.
Cooperation of officers, owners, and employees.
(1) As used in this section:
(a) "Cooperate" includes to:
(i) reply promptly in writing to an inquiry from the commissioner or receiver requesting a reply; and
(ii) promptly make available to the commissioner or receiver any record, account, information, or property:
(A) of or pertaining to the insurer; and
(B) in the person's possession, custody, or control.
(b) "Person" includes a person who exercises control directly or indirectly over activities of the insurer through:
(i) a holding company; or
(ii) other affiliate of the insurer.
(2) The following shall cooperate with the commissioner or receiver in a proceeding under this chapter or an investigation preliminary to a proceeding under this chapter:
(a) a present or former officer, manager, director, trustee, owner, or employee of an insurer;
(b) a present or former agent of an insurer; or
(c) a person with authority over or in charge of any segment of the insurer's affairs.
(3) A person may not obstruct or interfere with the commissioner or receiver in the conduct of:
(a) a delinquency proceeding; or
(b) an investigation preliminary or incidental to a delinquency proceeding.
(4) This section may not be construed to abridge otherwise existing legal rights, including the right to resist:
(a) a petition for liquidation or other delinquency proceeding; or
(b) other orders.
(5)
(a) A person described in Subsection (5)(b) is:
(i) guilty of a class B misdemeanor, except that the fine may exceed $1,000 but may not exceed $10,000; or
(ii) after a hearing, subject to:
(A) the commissioner imposing a civil penalty that may not exceed $10,000;
(B) the revocation or suspension of an insurance license issued by the commissioner; or
(C) a combination of Subsections (5)(a)(ii)(A) and (B).
(b) This Subsection (5) applies to:
(i) a person described in Subsection (2) who fails to cooperate with the commissioner or receiver;
(ii) a person who obstructs or interferes with the commissioner or receiver in the conduct of a delinquency proceeding or an investigation preliminary or incidental to a delinquency proceeding; or
(iii) a person who violates an order validly issued under this chapter.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 112 - Unrecorded obligations and defenses of affiliates.

31A-27a-112.
Unrecorded obligations and defenses of affiliates.
(1) This section applies to a person who in relation to an insurer is:
(a) an affiliate;
(b) a controlled or controlling person; or
(c) a present or former officer, manager, director, trustee, or shareholder.
(2) In a proceeding or claim by the receiver, a person described in Subsection (1) may not assert a defense unless evidence of the defense:
(a) is recorded in the records of the insurer at or about the time the event giving rise to the defense occurs; and
(b) if required by statutory accounting practices and procedures, is timely reported on the insurer's official financial statements filed with the commissioner.
(3) A person described in Subsection (1) may not assert a claim, unless the obligation:
(a) is recorded in the records of the insurer at or about the time the obligation is incurred; and
(b) if required by statutory accounting practices and procedures, is timely reported on the insurer's official financial statements filed with the commissioner.
(4) A claim by the receiver against a person described in Subsection (1) that is made on the basis of an unrecorded or unreported transaction is not barred by this section.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 113 - Executory contracts.

31A-27a-113.
Executory contracts.
(1) Subject to the other provisions of this section, the receiver may assume or reject an executory contract or unexpired lease of the insurer.
(2)
(a) If there is a default in an executory contract or unexpired lease of the insurer, the receiver may not assume the contract or lease unless, at the time of the assumption of the contract or lease, the receiver:
(i) cures or provides adequate assurance that the receiver will promptly cure the default; and
(ii) provides adequate assurance of future performance under the contract or lease.
(b) This Subsection (2) does not apply to a default that is a breach of a provision relating to:
(i) the insolvency or financial condition of the insurer at any time before the closing of the delinquency proceeding;
(ii) the appointment of or taking possession by:
(A) a receiver in a case under this chapter; or
(B) a custodian before the commencement of the delinquency proceeding; or
(iii) the satisfaction of a penalty rate or provision relating to a default arising from a failure of the insurer to perform a nonmonetary obligation under the executory contract or unexpired lease.
(3) A claim arising from a rejection under this section or under a plan of rehabilitation or liquidation of an executory contract or unexpired lease of the insurer that is not assumed shall be determined, and shall be treated and classified as though the claim arose before the day on which a successful petition commencing the delinquency proceeding is filed.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 115 - Approval and payment of expenses.

31A-27a-115.
Approval and payment of expenses.
(1) The receiver may pay an expense under a contract, lease, employment agreement, or other arrangement entered into by the insurer before receivership, as the receiver considers necessary for the purposes of this chapter. The receiver:
(a) is not required to pay an expense described in this Subsection (1) that the receiver determines is not necessary; and
(b) may reject a contract pursuant to Section 31A-27a-113.
(2) Receivership expenses other than those described in Subsection (1) shall be paid as follows:
(a) unless the court orders otherwise in the rehabilitation or liquidation order, the receiver may submit a motion pursuant to Section 31A-27a-107 to the receivership court to approve:
(i) the terms of compensation of each special deputy or contractor; or
(ii) any other expense in excess of an amount established by this chapter;
(b) the receiver may, as the receiver considers appropriate, submit a motion to approve any other compensation, anticipated expense, or incurred expense not described in Subsection (2)(a);
(c) the receiver may pay as incurred:
(i) an expense not requiring receivership court approval; and
(ii) an expense approved in the rehabilitation or liquidation order; and
(d) the approval of an expense by the receivership court may not prejudice the right of the receiver to seek recovery, recoupment, disgorgement, or reimbursement of a fee based on contract or a cause of action recognized in law or in equity.
(3) On an annual or more frequent basis, the receiver shall submit to the receivership court a report summarizing the expenses incurred in the prior period.
(4) Receivership court approval is not required to pay expenses incurred by the receiver in connection with the appeal of an order of the receivership court.
(5) All expenses of receivership shall be paid from the assets of the insurer, except as provided in this Subsection (5).
(a) If the property of the insurer does not contain sufficient cash or liquid assets to defray the expenses incurred, the commissioner may advance funds from the account established under Subsection 31A-27a-705(3).
(b) An amount advanced shall be repaid to the account out of the first available money of the insurer.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 116 - Financial reporting.

Effective 5/12/2015
31A-27a-116.
Financial reporting.
(1)
(a) The receiver shall comply with all requirements for receivership financial reporting in this section and as may be specified by the commissioner by rule or ordered by the court within:
(i) 180 days after the day on which the receivership court enters an order of receivership; and
(ii) 45 days following each calendar quarter after the period specified in Subsection (1)(a)(i).
(b) The rule described in this Subsection (1) shall:
(i) comply with this section;
(ii) be made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and
(iii) require the receiver to file any financial report with the receivership court in addition to any other person specified in the rule.
(c) A financial report shall include, at a minimum, a statement of:
(i) the assets and liabilities of the insurer;
(ii) the changes in those assets and liabilities; and
(iii) all funds received or disbursed by the receiver during that reporting period.
(d) The receiver may qualify a financial report or provide notes to the financial statement for further explanation.
(e) The receivership court may order the receiver to provide any additional information as the receivership court considers appropriate.
(2) Each affected guaranty association shall file one or more reports with the liquidator:
(a)
(i) within 180 days after the day on which the receivership court enters an order of liquidation; and
(ii)
(A) within 45 days following each calendar quarter after the period described in Subsection (2)(a)(i); or
(B) at an interval:
(I) agreed to between the liquidator and the affected guaranty association; or
(II) required by the receivership court; and
(b) in no event less than annually.
(3) For good cause shown, the receivership court may grant:
(a) relief for an extension or modification of time to comply with Subsection (1) or (2); or
(b) such other relief as may be appropriate.
Amended by Chapter 244, 2015 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 117 - Records.

31A-27a-117.
Records.
(1)
(a) Upon entry of an order of rehabilitation or liquidation, the receiver is vested with title to all of the records of the insurer:
(i) of whatever nature;
(ii) in whatever medium;
(iii) wherever located; and
(iv) regardless of whether the item is in the custody and control of:
(A) a third party administrator;
(B) a managing general agent;
(C) an attorney; or
(D) other representatives of the insurer.
(b) The receiver may immediately take possession and control of:
(i) all of the records of the insurer; and
(ii) the premises where the records are located.
(c) At the request of the receiver, a third party administrator, managing general agent, attorney, or other representatives of the insurer shall release all records of the insurer to:
(i) the receiver; or
(ii) the receiver's designee.
(d) With the receiver's approval, an affected guaranty association with an obligation under a policy issued by the insurer may take actions necessary to obtain directly from a third party administrator, managing general agent, attorney, or other representative of the insurer all records pertaining to the insurer's business that are appropriate or necessary for the affected guaranty association to fulfill its statutory obligations.
(2) The receiver may certify a record of a delinquent insurer described in Subsection (1) and a record of the receiver's office created and maintained in connection with a delinquent insurer, as follows:
(a) a record of a delinquent insurer may be certified by the receiver in an affidavit stating that the record is a true and correct copy of the record of the insurer that is received from the custody of the insurer, or found among the insurer's effects; or
(b) a record created by or filed with the receiver's office in connection with a delinquent insurer may be certified by the receiver's affidavit stating that the record is a true and correct copy of the record maintained by the receiver's office.
(3)
(a) An original record or copy of a record certified under Subsection (2):
(i) when admitted in evidence is prima facie evidence of the facts disclosed; and
(ii) is admissible in evidence in the same manner as a document described in Utah Rules of Evidence, Rule 902(1).
(b) The receivership court may consider the certification of a record by the receiver pursuant to this section as satisfying the requirements of Utah Rules of Evidence, Rule 803(6).
(4) A record of a delinquent insurer held by the receiver:
(a) is not a record of the department for any purposes; and
(b) not subject to Title 63G, Chapter 2, Government Records Access and Management Act.
Amended by Chapter 382, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 118 - Commissioner's reports.

31A-27a-118.
Commissioner's reports.
(1) The commissioner shall include in the commissioner's annual report:
(a) the names of the insurers proceeded against under Sections 31A-27a-207 and 31A-27a-901;
(b) those facts which indicate in reasonable detail the commissioner's formal proceedings under this chapter; and
(c) those facts which generally explain the use and effectiveness of proceedings under Chapter 27, Part 5, Administrative Actions, and Section 31A-27a-901.
(2) The commissioner as receiver shall make and file annual reports and any other required reports for an insurer proceeded against under Sections 31A-27a-207 and 31A-27a-901 in the manner, in the form, and within the time required by law of an insurer authorized to do business in this state.
Renumbered and Amended by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 119 - Delinquency proceeding commenced before April 30, 2007.

31A-27a-119.
Delinquency proceeding commenced before April 30, 2007.
This chapter does not apply to a delinquency proceeding ongoing on April 30, 2007.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 1 - General Provisions › Section 120 - Severability.

31A-27a-120.
Severability.
If any provision of this chapter or the application of this chapter to any person or circumstance is for any reason held invalid, the remainder of the chapter and the application of the provision to other persons or circumstances shall be given effect without the invalid provision or application. The provisions of this chapter are severable.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 2 - Proceedings › Section 202 - Commencement of formal delinquency proceeding.

31A-27a-202.
Commencement of formal delinquency proceeding.
(1) A formal delinquency proceeding against a person shall be commenced by filing a petition in the name of the commissioner or department.
(2)
(a) The petition required by Subsection (1):
(i) shall state:
(A) the grounds upon which the proceeding is based; and
(B) the relief requested; and
(ii) may include a request for restraining orders and injunctive relief as described in Section 31A-27a-108.
(b) Upon the filing of a petition, the commissioner shall forward a notice of the petition by first-class mail or electronic communication, as permitted by the receivership court, to the commissioners and guaranty associations in states in which the insurer did business.
(3)
(a) A petition that requests injunctive relief:
(i) shall be verified by the commissioner or the commissioner's designee; and
(ii) is not required to plead or prove irreparable harm or inadequate remedy at law.
(b) The commissioner shall provide only the notice the receivership court requires.
(4) If a temporary restraining order is requested:
(a) the receivership court may issue an initial order containing the relief requested;
(b) the order shall state the time and date of its issuance;
(c) the receivership court shall set a time and date for the return of summons:
(i) not more than 10 days from the time and date the initial order is issued; and
(ii) at which time the person proceeded against may appear before the receivership court for a summary hearing; and
(d) the order may not continue in effect beyond the time and date set for the return of summons, unless the receivership court expressly enters one or more orders extending the restraining order.
(5)
(a) If no temporary restraining order is requested, the receivership court shall cause summons to be issued.
(b) The summons shall specify:
(i) a return date not more than 30 days after the day on which the summons is issued; and
(ii) that an answer shall be filed at or before the return date.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 2 - Proceedings › Section 203 - Return of summons and summary hearing.

31A-27a-203.
Return of summons and summary hearing.
(1) The receivership court shall hold a summary hearing at the time and date for the return of summons on a petition to commence a formal delinquency proceeding.
(2) If a person is not served with summons on a petition to commence a formal delinquency proceeding and fails to appear for the summary hearing, the receivership court shall:
(a) continue the summary hearing not more than 10 days;
(b) provide for alternative service of summons upon the person; and
(c) extend any restraining order.
(3) Upon a showing of good faith efforts to effect personal service upon a person who fails to appear for a continued summary hearing, the receivership court shall order notice of the petition to commence a formal delinquency proceeding to be published. The order and notice shall specify:
(a) a return date not less than 10 nor more than 20 days after the day on which notice is published; and
(b) that the restraining order is extended to the continued hearing date.
(4) If a person fails to appear for a summary hearing on a petition to commence a formal delinquency proceeding after service of summons, the receivership court shall enter judgment in favor of the commissioner against that person.
(5)
(a) A person who appears for the summary hearing on a petition to commence a formal delinquency proceeding shall file its answer at the hearing and the receivership court shall:
(i) determine whether to extend any temporary restraining order pending final judgment; and
(ii) set the case for trial on a date not more than 10 days from the day on which the summary hearing is held.
(b) The receivership court may not grant a continuance for filing an answer.
Enacted by Chapter 309, 2007 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 27a - Insurer Receivership Act › Part 2 - Proceedings › Section 204 - Proceedings for expedited trial -- Continuance -- Evidence -- Discovery.

31A-27a-204.
Proceedings for expedited trial -- Continuance -- Evidence -- Discovery.
(1)
(a) The receivership court shall proceed to hear the case on the petition to commence a formal delinquency proceeding:
(i) at the time and date set forth for trial;
(ii) without a jury; and
(iii) without unnecessary delay.
(b) To the extent practicable, the receivership court shall give precedence to the matter over all other matters.
(c) To the extent authorized by law, the receivership court may assign the matter to another judge if necessary to comply with the need for expedited proceedings under this chapter.
(2) A continuance for trial shall be granted only in extreme circumstances.
(3) The receivership court shall admit as self authenticated a certified copy of the following when offered by the commissioner:
(a) a financial statement made by the insurer or an affiliate;
(b) an examination report of the insurer or an affiliate made by or on behalf of the commissioner; or
(c) any other document filed with any insurance department by the insurer or an affiliate.
(4) The facts contained in an examination report of the insurer or an affiliate made by or on behalf of the commissioner is presumed to be true as of the date of the hearing if the examination is made as of a date not more than 270 days before the day on which the petition is filed. The presumption:
(a) is rebuttable; and
(b) shifts the burden of production and persuasion to the insurer.
(5) Discovery:
(a) is limited to grounds alleged in the petition; and
(b) shall be concluded on an expedited basis.
Enacted by Chapter 309, 2007 General Session