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| 56-12-107. Powers and duties of
association. -
(a) The association shall:
- (A) Be obligated to the extent of the covered claims
existing prior to the determination of insolvency and arising within
thirty ( 30 ) days after the determination of insolvency, or before the
policy expiration date if less than thirty ( 30 ) days after the
determination, or before the insured replaces the policy or on request
effects cancellation, if the insured does so within thirty ( 30 ) days of the
determination, but the obligation shall include only that amount of each
covered claim that is in excess of one hundred dollars ( $100 ) and is
less than one hundred thousand dollars ( $100,000 ), except that the
association shall pay the full amount of any covered claim arising out of
a workers' compensation policy. In no event shall the association be
obligated to a policyholder or claimant in an amount in excess of the
obligation of the insolvent insurer under the policy from which the claim
arises;
(B) In the case of claims other than
workers' compensation arising from bodily injury, sickness, or disease,
including death resulting from bodily injury, sickness, or disease, the amount for which the association
shall be obligated shall not exceed the claimant's reasonable expenses
incurred for necessary medical, surgical, X-ray and dental services,
including prosthetic devices and necessary ambulance, hospital,
professional nursing and funeral services, and any amounts actually lost by
reason of claimant's inability to work and earn wages or salary or their
equivalent that would otherwise have been earned in the normal course of
such injured claimant's employment, to which may be added at the
discretion of the association an additional sum as compensation for
permanent physical impairment if the payment can be made within the
policy limits;
(C) (i) Any obligation of the association to defend an
insured shall cease upon the association's payment, by settlement
releasing the insured or on a judgment, of any amount equal to the lesser
of the association's covered claim obligation limit or the applicable
policy limit;
(ii) Notwithstanding any other provisions of this part,
except in the case of a claim for benefits under workers' compensation
coverage, any obligation of the association to any and all persons shall
cease when ten million dollars ($ 10,000,000 ) has been paid in the
aggregate to or on behalf of any single insured and its affiliates by the
association and any one ( 1 ) or more associations similar to the
association of any other state or states or any property and casualty
security fund which obtains contributions from insurers on a
pre-insolvency basis, on covered claims or allowed claims arising under
the policy or policies of any one insolvent insurer. For the purposes of
this section, "affiliate" means a person who directly, or
indirectly, through one (1) or more intermediaries, controls, is controlled
by, or is under common control with another person. If the association
determines that there may be more than one (1) claimant having a covered claim
or allowed claim against the association or any associations similar to
the association or any property and casualty insurance security fund in
other states, under the policy or policies of any one (1) insolvent
insurer, the association may establish a plan to allocate amounts payable
by the association in the manner that the association in its discretion
deems equitable;
- Be deemed the insurer to the extent of its obligation
on the covered claims and to this extent shall have all rights, duties, and
obligations of the insolvent insurer as if the insurer had not become
insolvent including, but not limited to, the right to pursue and retain
salvage and subrogation recoverable on paid covered claim obligations. The
association shall not be deemed the insolvent insurer for any purpose
relating to the issue of whether the association is amenable to the
personal jurisdiction of the courts of any other state;
- Allocate claims paid and expenses incurred among the
two (2) accounts separately, and assess member insurers separately for
each account amounts necessary to pay the obligations of the association
under subdivision (a)(1) subsequent to an insolvency, the expenses of
handling covered claims subsequent to an insolvency, and expenses
authorized by this part. The assessments of each member insurer shall be
in the proportion that the net direct written premiums of the member
insurer for the preceding calendar year on the kinds of insurance in the
account bears to the net direct written premiums of all member insurers
for the preceding calendar year on the kinds of insurance in the account.
Each member insurer shall be notified of the assessment not later than
thirty (30) days before it is due. No member insurer may be assessed in
any year on any account an amount greater than two percent ( 2%) of that
member insurer's net direct written premiums for the preceding calendar
year on the kinds of insurance in the account. If the maximum assessment,
together with the other assets of the association in any account, does not
provide in any one (1) year in any account an amount sufficient to make
all necessary payments from that account, the funds available shall be
prorated and the unpaid portion shall be paid as soon thereafter as
funds become available. The association may exempt or defer, in whole or
in part, the assessment of any member insurer, if the assessment would
cause the member insurer's financial statement to reflect amounts of
capital or surplus less than the minimum amounts required for a
certificate of authority by any jurisdiction in which the member insurer
is authorized to transact insurance. Each member insurer may set off
against any assessment, authorized payments made on covered claims and
expenses incurred in the payment of the claims by the member insurer if
they are chargeable to the account for which the assessment is made;
- Investigate claims brought against the association and
adjust, compromise, settle, and pay covered claims to the extent of the
association's obligation and deny all other claims and may review
settlements, releases and judgments to which the insolvent insurer or its
insureds were parties to determine the extent to which the settlements,
releases and judgments may be properly contested;
- Notify such persons as the commissioner directs under §
56-12-109(b)(1) ;
- Handle claims through its employees or through one (1) or more insurers or other persons designated as servicing facilities.
Designation of a servicing facility is subject to the approval of the
commissioner, but such designation may be declined by a member insurer;
and
- Reimburse each servicing facility for obligations of
the association paid by the facility and for expenses incurred by the
facility while handling claims on behalf of the association and shall pay
the other expenses of the association authorized by this part.
(b) The Association may:
- Appear in, defend, and appeal any action on a claim
brought against the association;
- Employ or retain such persons as are necessary to
handle claims and perform other duties of the association;
- Borrow funds necessary to effect the purposes of this
part in accordance with the plan of operation. In the event of an
insolvency resulting in covered claims payable by the association in
excess of its capacity to pay from assessments under subdivision (a)(3), the association, in its sole discretion, may by resolution request the
local development authority to issue bonds and/or notes pursuant to title
4, chapter 31, part 8, in such amounts as the association may determine
necessary to provide funds for the payments of covered claims and expenses
related thereto. However, the amount of the bond issuance may be
limited by §§ 4-31-804 and 4-31-805 with the local
development authority having the final authority to determine the total
amount of the bond issuance including issuance costs. When the
association and the local development authority agree that bond or notes
shall be issued to pay covered claims in the event of an insolvency, the
association shall have the authority to annually assess member insurers
for amounts necessary to secure and provide for the repayment of the
indebtedness, including, without limitation, the principal, redemption
premium, if any, and interest on, and related costs of issuance of such
indebtedness including bond investors insurance. Necessary assessments
collected pursuant to this authority shall be collected under the same
procedures provided in subdivision (a)(3). Assessments collected
under this section may be assigned and pledged to or on behalf of the
local development authority for the benefit of the holders of such
indebtedness, in order to provide for the payment of the principal of,
redemption premium, if any, and interest on such indebtedness, the cost of
issuance, and the funding of any reserves and any other payments under the
documents under which the indebtedness was incurred. In addition to the
assessments provided for this section, the association in its sole
discretion may utilize assessments made under subdivision (a)(3),
to service such indebtedness, if necessary. The association shall have no
obligation to pay covered claims solely from the proceeds of bonds or
notes issued under § 4-31-804; provided, that if the association
may cause assessments to be made hereunder for such covered claims, and
assigns and pledges such assessments to or on behalf of the local
development authority as issuer of such indebtedness for the benefit of
the holders of bonds or notes, the association may administer such covered
claims and present valid covered claims for payment;
- Sue or be sued, and such power to sue includes the
power and right to intervene as a party before any court that has
jurisdiction over an insolvent insurer as defined by this part;
- Negotiate and become a party to such contracts as are
necessary to carry out the purpose of this part;
- Perform such others acts as are necessary or proper to
effectuate the purpose of this part; and
- Refund to the member insurers in proportion to the
contribution of each member insurer to that account that amount by which
the assets of the account exceed the liabilities, if, at the end of any
calendar year, the board of directors finds that the assets of the
association in any account exceed the liabilities of that account as
estimated by the board of directors for the coming year.
(c) With respect to any suit
involving the association:
- Any action relating to or arising out of this part
against the association shall be brought in a court in this state. Such
court shall have exclusive jurisdiction over any action relating to or
arising out of this part against the association; and
- Exclusive venue in any action brought against the
association is in the circuit of chancery court in Davidson County,
provided, that the association may waive such venue as to a
specific action.
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[Acts 1971, ch. 180 § 7; 1975, ch. 62, §§ 5, 6;
1977, ch. 203, § 3; T.C.A., § 56-4007; Acts 1995, ch. 240, § 2; 1999, ch. 48, §§ 3-6, 11.]
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