reglab/statecodes huggingface dataset:
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 3 - TIME-PRICE DIFFERENTIAL PAYMENT OF AGENTS (§§ 56-6-301 — 56-6-307) › Section 56-6-307 - Inapplicable to certain agents

This part does not apply to agents who finance premiums through a Tennessee corporation, or a corporation domesticated to transact business in Tennessee, that is either an insurer, a subsidiary of an insurer or owned by a group of insurers, and that confines its business to the financing of insurance premiums on policies issued by the owners of the company.
Acts 1965, ch. 356, § 7; T.C.A., § 56-720.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-401 - "Administrator" defined

As used in this part, "administrator" means any person, company, corporation, partnership, association or other legal entity that collects charges or premiums from, or that adjusts or settles claims on, residents of this state in connection with life or health insurance coverage or annuities other than:
(1)
An employer on behalf of its employees or the employees of one (1) or more subsidiary or affiliated corporations of the employer;
(2)
A union on behalf of its members;
(3)
An insurance company that is either licensed in this state or acting as an insurer with respect to a policy lawfully issued and delivered by it in and pursuant to the laws of a state in which the insurer was authorized to conduct an insurance business or a nonprofit hospital, medical, dental or vision service organization, including its sales representatives, licensed in this state when engaged in the performance of its duties as such, or a duly licensed health maintenance organization;
(4)
A life or health agent or broker licensed in this state, whose activities are limited exclusively to the sale of insurance, or sales-related services for which no monetary compensation is paid;
(5)
A creditor on behalf of its debtors with respect to insurance covering a debt between the creditor and its debtors;
(6)
A trust, its trustees, agents and employees acting under the trust, established in conformity with
29 U.S.C. § 186
;
(7)
A trust exempt from taxation under the Internal Revenue Code, § 501(a) (
26 U.S.C. § 501(a)
), its trustees, and employees acting under
26 U.S.C. § 501(a)
, or a custodian, its agents and employees acting pursuant to a custodian account that meets the requirements of the Internal Revenue Code, § 401(f) (
26 U.S.C. § 401(f)
);
(8)
A bank, credit union or other financial institution that is subject to supervision or examination by federal or state banking authorities;
(9)
A credit card issuing company that advances for and collects premiums or charges from its credit card holders who have authorized it to do so, provided the company does not adjust or settle claims; or
(10)
A person who adjusts or settles claims in the normal course of the person's practice or employment as an attorney at law, and who does not collect charges or premiums in connection with life or health insurance coverage or annuities.
Acts 1980, ch. 640, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-402 - Agreement required - Records - Terms

(a)
No administrator shall act as administrator without a written agreement between the administrator and the insurer, and the written agreement shall be retained as part of the official records of both the insurer and the administrator for the duration of the agreement and five (5) years thereafter. The written agreement shall contain provisions that include the requirements of §§
56-6-404
- 56-6-408, except insofar as those requirements do not apply to the functions performed by the administrator.
(b)
Where a policy is issued to a trustee or trustees, a copy of the trust agreement and any amendments to the trust agreement shall be furnished to the insurer by the administrator and shall be retained as part of the official records of both the insurer and the administrator for the duration of the policy and five (5) years thereafter.
(c)
The agreement between administrator and insurer shall make provision with respect to the underwriting or other standards pertaining to the business underwritten by the insurer.
Acts 1980, ch. 640, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-403 - Payments handled by administrator

Whenever an insurer utilizes the services of an administrator under the terms of a written contract as required in §
56-6-402
, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured shall be deemed to have been received by the insurer, and the payment of return premiums or claims by the insurer to the administrator shall not be deemed payment to the insured or claimant until the payments are received by the insured or claimant. Nothing in this section shall limit any right of the insurer against the administrator resulting from its failure to make payments to the insurer, insureds or claimants.
Acts 1980, ch. 640, § 3.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-404 - Recordkeeping requirements

(a)
Every administrator shall maintain at its principal administrative office, for the duration of the written agreement referred to in §
56-6-402
and five (5) years thereafter, adequate books and records of all transactions between it, insurers and insured persons. The books and records shall be maintained in accordance with prudent standards of insurance record keeping. The commissioner shall have access to the books and records for the purpose of examination, audit and inspection.
(b)
Any trade secrets contained in the books and records, including, but not limited to, the identity and addresses of policyholders and certificate holders, shall be confidential, except the commissioner may use the information in any proceedings instituted against the administrator.
(c)
The insurer shall retain the right to continuing access to the books and records of the administrator sufficient to permit the insurer to fulfill all of its contractual obligations to insured persons, subject to any restrictions in the written agreement between the insurer and administrator concerning the proprietary rights of the parties in the books and records.
(d)
The commissioner shall collect the proper charges incurred in the examination in accordance with §
56-1-413
.
Acts 1980, ch. 640, § 4.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-405 - Advertising

An administrator may use only advertising pertaining to the business underwritten by an insurer that has been approved by the insurer in advance of its use.
Acts 1980, ch. 640, § 5.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 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:
(1)
Remittance to an insurer entitled to the remittance;
(2)
Deposit in an account maintained in the name of the insurer;
(3)
Transfer to and deposit in a claims paying account, with claims to be paid as provided in §
56-6-407
;
(4)
Payment to a group policyholder for remittance to the insured entitled to the remittance;
(5)
Payment to the administrator of its commission, fees or charges; or
(6)
Remittance of return premiums to the person or persons entitled to the remittance.
Acts 1980, ch. 640, § 6.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 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.
Acts 1980, ch. 640, § 7; 1996, ch. 691, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-408 - Administrator's compensation not contingent on claim experience

(a)
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.
(b)
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.
Acts 1980, ch. 640, § 8.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-409 - Notice to insured persons - Notice to persons purchasing coverage

(a)
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.
(b)
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.
Acts 1980, ch. 640, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-410 - License requirements

(a)
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.
(b)
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.
(c)
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.
Acts 1980, ch. 640, § 10; 1981, ch. 297, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 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:
(1)
Whether the person acting as an administrator is primarily in a business other than that of administrator;
(2)
Whether the financial strength or history of the organization indicates stability in its continuity of doing business; and
(3)
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.
Acts 1980, ch. 640, § 11.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 4 - ADMINISTRATORS (§§ 56-6-401 — 56-6-412) › Section 56-6-412 - Federally regulated trusts

This part shall not be applicable to those trusts regulated by the federal government.
Acts 1980, ch. 640, § 12.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 56-6-501 - Short title

This part shall be known and may be cited as the "Managing General Agents Act."
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 56-6-502 - Part definitions

As used in this part, unless the context otherwise requires:
(1)
"Actuary" means a person who is a member in good standing of the American Academy of Actuaries;
(2)
"Insurer" means any person, firm, association or corporation duly licensed in this state as an insurance company pursuant to §
56-2-102
;
(3)
(A)
"Managing general agent" or "MGA" means any person who:
(i)
Manages all or part of the insurance business of an insurer, including the management of a separate division, department, or underwriting office; and
(ii)
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:
(a)
Adjusts or pays claims in excess of ten thousand dollars ($10,000) per claim; or
(b)
Negotiates reinsurance on behalf of the insurer;
(B)
Notwithstanding subdivision (3)(A), the following persons shall not be considered as MGAs for the purposes of this part:
(i)
An employee of the insurer;
(ii)
A United States manager of the United States branch of an alien insurer;
(iii)
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
(iv)
The attorney-in-fact authorized by and acting for the subscribers of a reciprocal insurer or inter-insurance exchange under powers of attorney; and
(4)
"Underwrite" means the authority to accept or reject risk on behalf of the insurer.
Amended by 2018 Tenn. Acts, ch. 873,s 10, eff. 5/3/2018.
Acts 1991, ch. 142, § 7; 1992, ch. 768, § 1.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 56-6-503 - Requirements for acting in capacity of an MGA - Bond - Errors and omissions policy

(a)
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.
(b)
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.
(c)
The commissioner may require a bond in an amount acceptable to the commissioner for the protection of the insurer.
(d)
The commissioner may require the MGA to maintain an errors and omissions policy.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 56-6-505 - Insurers doing business with an MGA - Requirements

(a)
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.
(b)
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.
(c)
The insurer shall periodically, at least semi-annually, conduct an on-site review of the underwriting and claims processing operations of the MGA.
(d)
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.
(e)
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.
(f)
(1)
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.
(2)
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.
(g)
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.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 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.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 56-6-507 - Violations of provisions of part - Penalties

(a)
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:
(1)
For each separate violation, a penalty in an amount of five thousand dollars ($5,000);
(2)
Revocation or suspension of the producer's license; and
(3)
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.
(b)
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.
(c)
Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided for in the insurance law.
(d)
Nothing contained in this part is intended to or shall in any manner limit or restrict the rights of policyholders, claimants and auditors.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 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.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 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.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 5 - MANAGING GENERAL AGENTS ACT (§§ 56-6-501 — 56-6-510) › Section 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.
Acts 1991, ch. 142, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 6 - BUSINESS TRANSACTED WITH PRODUCER CONTROLLED PROPERTY/CASUALTY INSURER ACT (§§ 56-6-601 — 56-6-604) › Section 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."
Acts 1991, ch. 142, § 8.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 6 - BUSINESS TRANSACTED WITH PRODUCER CONTROLLED PROPERTY/CASUALTY INSURER ACT (§§ 56-6-601 — 56-6-604) › Section 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:
(1)
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;
(2)
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;
(3)
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;
(4)
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;
(5)
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
(6)
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.
Acts 1991, ch. 142, § 8; 1993, ch. 253, § 13.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 6 - BUSINESS TRANSACTED WITH PRODUCER CONTROLLED PROPERTY/CASUALTY INSURER ACT (§§ 56-6-601 — 56-6-604) › Section 56-6-604 - Violations of part - Hearing - Penalties

(a)
(1)
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
(2)
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.
(b)
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.
(c)
Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided for in this title.
(d)
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.
Acts 1991, ch. 142, § 8; 1993, ch. 253, § 14.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 7 - HEALTH CARE SERVICE UTILIZATION REVIEW ACT (§§ 56-6-701 — 56-6-706) › Section 56-6-701 - Short title

This part shall be known and may be cited as the "Health Care Service Utilization Review Act."
Acts 1992, ch. 812, § 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 7 - HEALTH CARE SERVICE UTILIZATION REVIEW ACT (§§ 56-6-701 — 56-6-706) › Section 56-6-702 - [Effective Until 1/1/2025] Purpose

The purpose of this part is to:
(1)
Promote the delivery of quality health care in a cost-effective manner;
(2)
Assure that utilization review agents adhere to reasonable standards for conducting utilization review;
(3)
Foster greater coordination and cooperation between health care providers and utilization review agents;
(4)
Improve communications and knowledge of benefit plan requirements among all parties concerned before expenses are incurred; and
(5)
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).
Acts 1992, ch. 812, § 3; 2002, ch. 799, § 1.
This section is set out more than once due to postponed, multiple, or conflicting amendments.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 7 - HEALTH CARE SERVICE UTILIZATION REVIEW ACT (§§ 56-6-701 — 56-6-706) › Section 56-6-702 - [Effective 1/1/2025] Purpose

The purpose of this part is to:
(1)
Promote the delivery of quality health care in a cost-effective manner;
(2)
Assure that utilization review agents adhere to reasonable standards for utilization review, including adherence to the Prior Authorization Fairness Act, compiled in chapter 7, part 37 of this title;
(3)
Foster greater coordination and cooperation between healthcare providers and utilization review agents, including adherence to the Prior Authorization Fairness Act;
(4)
Improve communications and knowledge of benefit plan requirements among all parties concerned before expenses are incurred; and
(5)
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).
Amended by 2023 Tenn. Acts, ch. 395, s 1, eff. 1/1/2025.
Acts 1992, ch. 812, § 3; 2002, ch. 799, § 1.
This section is set out more than once due to postponed, multiple, or conflicting amendments.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 7 - HEALTH CARE SERVICE UTILIZATION REVIEW ACT (§§ 56-6-701 — 56-6-706) › Section 56-6-704 - Utilization review agents

(a)
Utilization review agents shall adhere to the minimum standards set forth in §
56-6-705
. Utilization review programs for the mental health and chemical dependency care must comply with the most recent requirements of nationally recognized utilization review accrediting bodies, i.e., the utilization review accreditation commission (URAC) and the national committee for quality assurance (NCQA), if the agent is accredited and with all final security and privacy rules on protected health information as defined in the Health Insurance Portability and Accountability Act (HIPAA). However, nothing in this part shall be construed to require compliance with the final security and privacy rules of HIPAA prior to the compliance dates set by the secretary of health and human services.
(b)
(1)
A utilization review agent may not conduct utilization review in this state unless the utilization review agent has certified to the commissioner in writing that the agent is in compliance with §
56-6-705
. Certification shall be made annually on or before July 1 of each calendar year. In addition, a utilization review agent shall file the following information:
(A)
The name, address, telephone number, and normal business hours of the utilization review agent;
(B)
The name and telephone number of a person for the commissioner to contact;
(C)
A description of the appeal procedures for utilization review determinations; and
(D)
Utilization review programs for mental health and chemical dependency care shall make available to a provider submitting patient utilization review information a description of utilization review standards and procedures applicable to that provider.
(2)
Any material changes in the information filed in accordance with this section shall be filed with the commissioner within thirty (30) days of the change.
(c)
Upon filing the certification, each utilization review agent shall pay an annual fee in the amount of one thousand dollars ($1,000) to the department. The commissioner shall exempt from payment of the annual fee any utilization review agent that has received accreditation by URAC or NCQA. All fees paid to the department under this part shall be held by the commissioner as expendable receipts for the purpose of administering this part.
Acts 1992, ch. 812, § 5; 1993, ch. 482, § 1; 2002, ch. 799, §§ 2, 3; 2009, ch. 611, §§ 1, 2.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 7 - HEALTH CARE SERVICE UTILIZATION REVIEW ACT (§§ 56-6-701 — 56-6-706) › Section 56-6-706 - Violations

(a)
Whenever the commissioner has reason to believe that a utilization review agent subject to this part has been or is engaged in conduct that violates this part, the commissioner shall notify the utilization review agent of the alleged violation. The utilization review agent has thirty (30) days from the date the notice is received to respond to the alleged violation.
(b)
If the commissioner believes the utilization review agent has violated this part, or is not satisfied that the alleged violation has been corrected, the commissioner may conduct a contested case hearing on the alleged violation in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(c)
If, after the hearing, the commissioner determines that the utilization review agent has engaged in violations of this part, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon the utilization review agent a copy of the findings and an order requiring the utilization review agent to cease and desist from engaging in the violations. The commissioner may also, at the commissioner's discretion, order:
(1)
Payment of a penalty of not more than ten thousand dollars ($10,000) in the aggregate for a violation that occurred with such frequency as to indicate a general business pattern or practice; or
(2)
Suspension or revocation of the authority to do business in this state as a utilization review agent if the utilization review agent knew the act was in violation of this chapter and repeated the act with such frequency as to indicate a general business pattern or practice.
Acts 1992, ch. 812, § 7.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-801 - Short title

This part shall be known and may be cited as the "Reinsurance Intermediary Act."
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-804 - Authorization of transactions

Transactions between an RB and the insurer the RB represents in that capacity shall only be entered into pursuant to a written authorization specifying the responsibilities of each party. The authorization shall, at a minimum, provide that:
(1)
The insurer may terminate the RB's authority at any time;
(2)
The RB will render accounts to the insurer accurately detailing all material transactions, including information necessary to support all commissions, charges, and other fees received by, or owing to, the RB, and remit all funds due to the insurer within thirty (30) days of receipt;
(3)
All funds collected for the insurer's account will be held by the RB in a fiduciary capacity in a bank that is a qualified United States financial institution as defined in §
56-6-802
;
(4)
The RB will comply with §
56-6-805
;
(5)
The RB will comply with the written standards established by the insurer for the cession or retrocession of all risks; and
(6)
The RB will disclose to the insurer any relationship with any reinsurer to which business will be ceded or retroceded.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-805 - Recordkeeping - Auditing by insurer

(a)
For at least ten (10) years after expiration of each contract of reinsurance transacted by the RB, the RB will keep a complete record for each transaction showing:
(1)
The type of contract, limits, underwriting restrictions, classes of risks and territory;
(2)
Period of coverage, including effective and expiration dates, cancellation provisions and notice required of cancellation;
(3)
Reporting and settlement requirements of balances;
(4)
Rate used to compute the reinsurance premium;
(5)
Names and addresses of assuming reinsurers;
(6)
Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the RB;
(7)
Related correspondence and memoranda;
(8)
Proof of placement;
(9)
Details regarding retrocessions handled by the RB including the identity of retrocessionaires and percentage of each contract assumed or ceded;
(10)
Financial records, including, but not limited to, premium and loss accounts; and
(11)
When the RB procures a reinsurance contract on behalf of a licensed ceding insurer:
(A)
Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or
(B)
If placed through a representative of the assuming reinsurer, other than an employee, written evidence that the reinsurer has delegated binding authority to the representative.
(b)
The insurer will have access to, and the right to copy and audit, all accounts and records maintained by the RB related to its business in a form usable by the insurer.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-806 - Use of reinsurance intermediary brokers restricted - Financial statements

(a)
An insurer shall not engage the services of any person, firm, association or corporation to act as an RB on its behalf unless the person is licensed as required by §
56-6-803(a)
.
(b)
An insurer may not employ an individual who is employed by an RB with which it transacts business, unless the RB is under common control with the insurer and subject to chapter 11 of this title.
(c)
The insurer shall annually obtain a copy of a statement of the financial condition of each RB with which it transacts business.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-808 - Prohibited acts

The RM shall not:
(1)
Cede retrocessions on behalf of the reinsurer, except that the RM may cede facultative retrocessions pursuant to obligatory facultative agreements if the contract with the reinsurer contains reinsurance underwriting guidelines for the retrocessions. The guidelines shall include a list of reinsurers with which the automatic agreements are in effect, and for each reinsurer, the coverages and amounts or percentages that may be reinsured and commission schedules;
(2)
Commit the reinsurer to participate in reinsurance syndicates;
(3)
Appoint any producer without assuring that the producer is lawfully licensed to transact the type of reinsurance for which the producer is appointed;
(4)
Without prior approval of the reinsurer, pay or commit the reinsurer to pay a claim, net of retrocessions, that exceeds the lesser of an amount specified by the reinsurer or one percent (1%) of the reinsurer's policyholders' surplus as of December 31 of the last complete calendar year;
(5)
Collect any payment from a retrocessionaire or commit the reinsurer to any claim settlement with a retrocessionaire, without prior approval of the reinsurer. If prior approval is given, a report must be promptly forwarded to the reinsurer;
(6)
Jointly employ an individual who is employed by the reinsurer unless the RM is under common control with the reinsurer subject to the Insurance Holding Company Act, compiled in chapter 11 of this title; or
(7)
Appoint a sub-RM.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-809 - Transactions between intermediaries

(a)
A reinsurer shall not engage the services of any person, firm, association or corporation to act as an RM on its behalf unless the person is licensed as required by §
56-6-803(a)
.
(b)
The reinsurer shall annually obtain a copy of statements of the financial condition of each RM that the reinsurer has engaged prepared by an independent certified accountant in a form acceptable to the commissioner.
(c)
If an RM establishes loss reserves, the reinsurer 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 RM. This opinion shall be in addition to any other required loss reserve certification.
(d)
Binding authority for all retrocessional contracts of participation in reinsurance syndicates shall rest with an officer of the reinsurer who shall not be affiliated with the RM.
(e)
Within thirty (30) days of termination of a contract with an RM, the reinsurer shall provide written notification of the termination to the commissioner.
(f)
A reinsurer shall not appoint to its board of directors any officer, director, employee, controlling shareholder or subproducer of its RM. This subsection (f) shall not apply to relationships governed by chapter 11 of this title.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-810 - Examinations by commissioner

A reinsurance intermediary shall be subject to examination by the commissioner. The commissioner shall have access to all books, bank accounts and records of the reinsurance intermediary in a form usable to the commissioner.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-811 - Violations - Penalties

(a)
A reinsurance intermediary, insurer or reinsurer found by the commissioner, after a hearing conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to be in violation of this part, shall:
(1)
For each separate violation, pay a penalty in an amount not exceeding five thousand dollars ($5,000);
(2)
Be subject to revocation or suspension of its license; and
(3)
If a violation was committed by the reinsurance intermediary, the reinsurance intermediary shall make restitution to the insurer, reinsurer, rehabilitator or liquidator of the insurer or reinsurer for the net losses incurred by the insurer or reinsurer attributable to the violation.
(b)
The decision, determination or order of the commissioner pursuant to subsection (a) shall be subject to judicial review in accordance with the Uniform Administrative Procedures Act.
(c)
Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided in this title.
(d)
Nothing contained in this part is intended to or shall in any manner limit or restrict the rights of policyholders, claimants, creditors or other third parties or confer any rights to those persons.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 8 - REINSURANCE INTERMEDIARY ACT (§§ 56-6-801 — 56-6-812) › Section 56-6-812 - Rules and regulations

The commissioner may adopt reasonable rules and regulations for the implementation and administration of this part.
Acts 1993, ch. 253, § 9.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 6 - AGENTS, SOLICITORS AND ADMINISTRATORS (§§ 56-6-101 — 56-6-1407) › Part 9 - TENNESSEE PUBLIC ADJUSTER LICENSING ACT OF 2006 (§§ 56-6-901 — 56-6-920) › Section 56-6-901 - Short title - Scope of part

(a)
This part shall be known and may be cited as the "Tennessee Public Adjuster Licensing Act of 2006."
(b)
This part governs the qualifications and procedures for the licensing of public adjusters. It specifies the duties of and restrictions on public adjusters, which include limiting their licensure to assisting insureds in first party claims.
Acts 2006, ch. 997, § 2.