374.010. The insurance department shall be charged with the execution of all laws now in force, or which may be hereafter enacted, in relation to insurance and insurance companies doing business in this state, and such other duties as are provided for by law.
(RSMo 1939 § 5780, A.L. 1990 H.B. 1739)Prior revisions: 1929 § 5670; 1919 § 6082; 1909 § 6877
374.020. 1. The chief officer of said department shall be designated as the director of the department of insurance. He shall be a citizen of this state, and experienced in matters of insurance, and be appointed by the governor, by and with the advice and consent of the senate, and shall hold his office concurrently with that of the governor and until his successor is appointed and qualified, and shall be subject to removal from office by the governor at his pleasure.
2. If a vacancy shall at any time occur, the same shall be filled by the governor, by appointment, subject to the confirmation of the senate, if in session; if not, then at its next session.
3. It shall not be lawful for the director or his deputy to hold any position as officer, agent or employee of any insurance or assurance company, nor shall he otherwise be directly or indirectly interested in any insurance company, except as a policyholder.
(RSMo 1939 § 5781, A.L. 1949 p. 300)Prior revisions: 1929 § 5671; 1919 § 6083; 1909 § 6878
374.030. Within twenty days after receiving his commission, and before entering upon the duties of his office, the director shall take the oath of office prescribed by the constitution of this state, and shall give a bond with a corporate surety or five or more good and sufficient sureties to the state of Missouri in the sum of two hundred fifty thousand dollars to be approved by the governor and attorney general, conditioned for the faithful discharge of his duty, which oath and bond shall be filed in the office of the secretary of state.
(RSMo 1939 § 5782, A. 1949 H.B. 2115, A.L. 1967 p. 516)Prior revisions: 1929 § 5672; 1919 § 6084; 1909 § 6879
374.040. 1. It shall be the duty of the director of the insurance department to file in his office and safely keep all books and papers required by law to be filed therein, to issue certificates of authority to transact insurance business in this state to any companies who have fully complied with the laws of this state, and to issue such other certificates as are required by the laws of this state in the organization of insurance companies and the transaction of the business of insurance, and generally to do and perform with justice and impartiality all such duties as are or may be imposed upon him by the laws regulating the business of insurance in this state and to perform those duties imposed upon him in such a manner as to be in the best interests of and protect the general public, policyholders, insurance companies, and the officers, directors and stockholders thereof; and every director shall, upon retiring from office, deliver to his qualified successor the possession of his office, and all furniture, papers and property belonging to the same.
2. Notwithstanding the provisions of sections 621.015 to 621.198, RSMo, whenever the director of insurance undertakes to issue, refuse, revoke or suspend the license or certificate of authority of an insurance company, fraternal benefit society, or reciprocal or interinsurance exchange, he shall proceed in accordance with the insurance laws of this state.
(RSMo 1939 § 5790, A.L. 1967 p. 516)Prior revisions: 1929 § 5680; 1919 § 6091; 1909 § 6885
CROSS REFERENCE:
Administrative hearing required on policy disapproval, RSMo 375.920
(1974) Disapproval of policy containing a "termination premium" was within power of director of insurance and termination penalty to be paid if insured cancelled within ten years discriminated against cancelling policyholder as opposed to policyholder who died within the same period. Survivor's Benefit Insurance Co. v. Farmer (Mo.), 514 S.W.2d 565.
374.045. 1. The director shall have the full power and authority to make all reasonable rules and regulations to accomplish the following purposes:
(1) To regulate the internal affairs of the department of insurance;
(2) To prescribe forms and procedures to be followed in proceedings before the department of insurance; and
(3) To effectuate or aid in the interpretation of any law of this state pertaining to the business of insurance.
2. The director may from time to time withdraw or amend any rule or regulation.
3. No rule or regulation shall conflict with any law of this state. No rule or portion of a rule promulgated under the authority of this chapter shall become effective unless it has been promulgated pursuant to the provisions of section 536.024, RSMo.
4. At least fifteen days prior to the adoption of any rule or regulation, or any amendment thereof, to be issued under the provisions of subdivision (3) of subsection 1, the director shall give notice of a hearing on the proposed action. The notice shall be mailed to all persons who have made timely requests of the department of insurance for advance notice of its rulemaking proceedings. The notice shall contain a statement of the terms or the substance of the proposed rule or regulation. In addition, the notice shall give the time and place where a hearing on the proposed rule or regulation will be held and the manner in which interested parties may present their views thereon. On the date of the hearing, all interested parties shall be given reasonable opportunity to present their views or arguments in writing or orally. The failure of any person to receive any notice of a hearing on any proposed rule or regulation shall not invalidate any rule or regulation subsequently adopted.
5. The willful violation of any rule or regulation shall subject the person violating it to such penalty as may be applicable and which the director has within his power to impose under the laws of this state relating to the business of insurance for violation of the law to which the rule or regulation relates.
6. Upon request and payment of the reasonable cost thereof, if required and fixed by the director, the director shall furnish a copy of any rule, regulation, or order to any person so requesting.
(L. 1967 p. 516, A.L. 1993 S.B. 52, A.L. 1995 S.B. 3)CROSS REFERENCE:
Director, certain rules and regulations prohibited, RSMo 375.920
374.046. 1. If the director determines based upon substantial and competent evidence that a person has engaged, is engaging in or has taken a substantial step toward engaging in an act, practice, omission, or course of business constituting a violation of the laws of this state relating to insurance in this chapter, chapter 354, RSMo, and chapters 375 to 385, RSMo, or a rule adopted or order issued pursuant thereto or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of the laws of this state relating to insurance in this chapter, chapter 354, RSMo, and chapters 375 to 385, RSMo, or a rule adopted or order issued pursuant thereto, the director may order the following relief:
(1) An order directing the person to cease and desist from engaging in the act, practice, omission, or course of business;
(2) A curative order or order directing the person to take other action necessary or appropriate to comply with the insurance laws of this state;
(3) Order a civil penalty or forfeiture as provided in section 374.049; and
(4) Award reasonable costs of the investigation.
2. In determining any relief sought, the director shall consider, among other factors, whether:
(1) The violations are likely to continue or reoccur;
(2) Actual financial loss was sustained by consumers and restitution has been made;
(3) The act, practice, omission, or course of business was detected as part of a self-audit or internal compliance program and immediately reported to the director; and
(4) The act, practice, omission, or course of business had previously been detected, but inadequate policies and procedures were implemented to prevent reoccurrence.
3. Unless the director determines that a summary order is appropriate under subsection 4 of this section, the director shall provide notice of the intent to initiate administrative enforcement by serving a statement of the reasons for the action upon any person subject to the proceedings. A statement of reasons, together with an order to show cause why a cease and desist order and other relief should not be issued, shall be served either personally or by certified mail on any person named therein. The director shall schedule a time and place at least ten days thereafter for hearing, and after notice of and opportunity for hearing to each person subject to the order, the director may issue a final order under subsection 6 of this section.
4. If the director determines that sections 375.014, 375.144, or 375.310, RSMo, are being violated and consumers are being aggrieved by the violations, the order issued under subdivision (1) of subsection 1 of this section may be summary and be effective on the date of issuance. Upon issuance of the order, the director shall promptly serve each person subject to the order with a copy of the order and a notice that the order has been entered.
5. A summary order issued under subsection 4 of this section must include a statement of the reasons for the order, notice within five days after receipt of a request in a record from the person that the matter will be scheduled for a hearing, and a statement whether the department is seeking a civil penalty or costs of the investigation. If a person subject to the order does not request a hearing and none is ordered by the director within thirty days after the date of service of the order, the order becomes final as to that person by operation of law. If a hearing is requested or ordered, the director, after notice of and opportunity for hearing to each person subject to the order, may modify or vacate the order or extend it until final determination.
6. If a hearing is requested or ordered pursuant to subsection 3 or subsection 5 of this section, a hearing before the director or a hearing officer designated by the director must be provided. A final order may not be issued unless the director makes findings of fact and conclusions of law in a record in accordance with the provisions of chapter 536, RSMo, and procedural rules promulgated by the director. The final order may make final, vacate, or modify the order issued under subsection 5 of this section.
7. In a final order under subsection 6 of this section, the director may impose a civil penalty or forfeiture as provided in section 374.049. No civil penalty or forfeiture may be imposed against a person unless the person has engaged in the act, practice, omission, or course of business constituting the violation.
8. In a final order under subsection 6 of this section, the director may charge the actual cost of an investigation or proceeding for a violation of the insurance laws of this state or a rule adopted or order issued pursuant thereto. These funds shall be paid to the director to the credit of the insurance dedicated fund.
9. The director is authorized to issue subpoenas, compel attendance of witnesses, administer oaths, hear testimony of witnesses, receive evidence, and require the production of books, papers, records, correspondence, and all other written instruments or documents relevant to the proceeding and authorized in contested cases under the provisions of chapter 536, RSMo, and procedural rules promulgated by the director.
10. Statements of charges, notices, orders, and other processes of the director may be served by anyone duly authorized by the director either in the manner provided by law for service of process in civil actions, or by registering or certifying and mailing a copy thereof to the person affected by such statement, notice, order, or other process at his or its residence or principal office or place of business. The verified return by the person so serving such statement, notice, order, or other process setting forth the manner of such service shall be proof of the same, and the return postcard receipt for such statement, notice, order, or other process, registered and mailed as aforesaid, shall be proof of the service of the same.
11. If a petition for judicial review of a final order is not filed in accordance with section 374.055, the director may file a certified copy of the final order with the clerk of a court of competent jurisdiction. The order so filed has the same effect as a judgment of the court and may be recorded, enforced, or satisfied in the same manner as a judgment of the court.
12. If a person violates or does not comply with an order under this section, the director may under section 374.048 petition a court of competent jurisdiction to enforce the order. The court may not require the director to post a bond in an action or proceeding under this section. If the court finds, after service and opportunity for hearing, that the person was not in compliance with the order, the court may, in addition to relief authorized in section 374.048, adjudge the person in civil contempt of the order. A violation of or failure to comply with an order under this section is a level three violation under section 374.049. The court may impose a further civil penalty against the person for contempt in an amount not less than five thousand dollars but not greater than one hundred thousand dollars for each violation and may grant any other relief the court determines is just and proper in the circumstances.
13. Until the expiration of the time allowed under section 374.055 for filing a petition for judicial review, if no such petition has been duly filed within such time or if a petition for review has been filed within such time, then until the transcript of the record in the proceeding has been filed in the circuit court of Cole County, the director may at any time, upon such notice and in such manner as he shall deem proper, modify or set aside in whole or in part any order issued by him under this section.
14. The enforcement authority of the director under this section is cumulative to any other statutory authority of the director.
15. The director is authorized to issue administrative consent orders in the public interest as complete or partial settlement of any investigation, examination, or other proceeding, which curative orders may contain any provision necessary or appropriate to assure compliance with the insurance laws of this state, require payment of restitution to be distributed directly or by the director to any aggrieved consumers, civil penalties, or voluntary forfeiture, reimbursement for costs of investigation or examination, or any other relief deemed by the director to be necessary and appropriate. Any remaining matters not addressed in settlement may be submitted to the director through a contested proceeding under this section.
16. (1) Any person willfully violating any provision of any cease and desist order of the director after it becomes final, while the same is in force, upon conviction thereof shall be punished by a fine of not more than one hundred thousand dollars, by imprisonment of up to ten years, or by both such fine and imprisonment.
(2) In addition to any other penalty provided, violation of any cease and desist order shall subject the violator to suspension or revocation of any certificate of authority or license as may be applicable under the laws of this state relating to the business of insurance.
17. The term "person" as used in this chapter shall include any individual, partnership, corporation, association or trust, or any other legal entity.
18. The term "order" as used in this chapter shall include a formal administrative direction or command of the director issued under this section or in any contested case subject to the provisions of section 536.063, RSMo, or any lawful administrative proceeding subject to judicial review, but shall not include department bulletins, no-action letters, advisory opinions, or any other statement of general applicability that should be adopted by rule.
(L. 1967 p. 516, A.L. 2006 H.B. 1837)(1984) Nothing in this section prevents the Governor from directing the division of insurance to issue a cease and desist order. American Family Life Assurance Co. v. Teasdale (8th Cir.) 733 F.2d 559.
374.047. 1. If the director determines, based on substantial and competent evidence, that a corporation or insurer with a certificate of authority under the laws relating to insurance willfully has engaged in an act, practice, omission, or course of business constituting a level three, four, or five violation of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, or been convicted of any felony or misdemeanor under any state or federal law, the director may, after hearing, issue an order suspending or revoking the certificate of authority.
2. Prior to issuance of the order under this section, the director shall give at least thirty days' notice with a statement of reasons for the action and afford such corporation or insurer the opportunity for a hearing upon written request. If such corporation or insurer requests a hearing in writing, a final order of suspension or revocation may not be issued unless the director makes findings of fact and conclusions of law in a record in accordance with the contested case provisions of chapter 536, RSMo, and procedural rules promulgated by the director.
3. The enforcement authority of the director under this section is cumulative to any other statutory authority of the director.
(L. 2006 H.B. 1837)
374.048. 1. If the director believes that a person has engaged, is engaging in or has taken a substantial step toward engaging in an act, practice, omission, or course of business constituting a violation of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, or a rule adopted or order issued pursuant thereto or that a person has or is engaging in an act, practice, omission, or course of business that materially aids a violation of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, or a rule adopted or order issued pursuant thereto, the director may maintain an action in the circuit court of any county of the state or any city not within a county to enjoin the act, practice, omission, or course of business and to enforce compliance with the laws of this state relating to insurance or a rule adopted or order issued by the director.
2. In an action under this section and on a proper showing, the court may:
(1) Issue a permanent or temporary injunction, restraining order, or declaratory judgment;
(2) Order other appropriate or ancillary relief, which may include:
(a) An asset freeze, accounting, writ of attachment, writ of general or specific execution, and appointment of a receiver or conservator, which may be the director, for the defendant or the defendant's assets;
(b) Ordering the director to take charge and control of a defendant's property, including accounts in a depository institution, rents, and profits; to collect debts; and to acquire and dispose of property;
(c) Imposing a civil penalty or forfeiture as provided in section 374.049;
(d) Upon showing financial loss, injury, or harm to identifiable consumers, imposing an order of restitution or disgorgement directed to a person who has engaged in an act, practice, omission, or course of business in violation of the laws or rules relating to insurance;
(e) Ordering the payment of prejudgment and postjudgment interest;
(f) Ordering reasonable costs of investigation and prosecution; and
(g) Ordering the payment to the insurance dedicated fund an additional amount equal to ten percent of the total restitution or disgorgement ordered, or such other amount as awarded by the court, which shall be appropriated to an insurance consumer education program administered by the director; or
(3) Order such other relief as the court considers necessary or appropriate.
3. The director may not be required to post a bond in an action or proceeding under this section.
4. The case may be brought in the circuit court of Cole County, any county or city not within a county in which a violation has occurred, or any county or city not within a county which has venue of an action against the person, partnership, or corporation under other provisions of law.
5. The enforcement authority of the director under this section is cumulative to any other authority of the director to impose orders under other provisions of the laws relating to insurance in this state.
6. If the director determines it to be in the public interest, the director is authorized to enter into a consent injunction and judgment in the settlement of any proceeding under the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo.
7. A "Consumer Restitution Fund" shall be created for the purpose of preserving and distributing to aggrieved consumers disgorgement or restitution funds obtained through enforcement proceedings brought by the director. In addition to the equitable powers of the court authorized above, the court may order that such funds be paid into the consumer restitution fund for distribution to aggrieved consumers. It shall be the duty of the director to distribute such funds to those persons injured by the unlawful acts, practices, omissions, or courses of business by the subject of the proceeding. Notwithstanding the provisions of section 33.080, RSMo, any funds remaining in the director's consumer restitution fund at the end of any biennium shall not be transferred to the general revenue fund, but if the director is unable with reasonable efforts to ascertain the aggrieved consumers, then the funds may be transferred to the insurance dedicated fund to be used for consumer education.
(L. 2006 H.B. 1837)
374.049. 1. Violations of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, or a rule adopted or order issued by the director, are classified for the purpose of civil penalties and forfeitures into the following five classifications:
(1) Level one violations;
(2) Level two violations;
(3) Level three violations;
(4) Level four violations; and
(5) Level five violations.
2. An order to impose a civil penalty or forfeiture, when imposed by the director in an administrative proceeding under section 374.046 on a person for any violation of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, or a rule adopted or order issued by the director, shall be an order to pay an amount not exceeding the following:
(1) No civil penalty or forfeiture for a level one violation;
(2) One thousand dollars per each level two violation, up to an aggregate civil penalty or forfeiture of fifty thousand dollars per annum for multiple violations;
(3) Five thousand dollars per each level three violation, up to an aggregate civil penalty or forfeiture of one hundred thousand dollars per annum for multiple violations;
(4) Ten thousand dollars per each level four violation, up to an aggregate civil penalty or forfeiture of two hundred fifty thousand dollars per annum for multiple violations;
(5) Fifty thousand dollars per each level five violation, up to an aggregate civil penalty or forfeiture of two hundred fifty thousand dollars per annum for multiple violations.
3. An order to impose a civil penalty or forfeiture, when imposed by the court in an enforcement proceeding under section 374.048 on a person for any violation of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, or a rule adopted or order issued by the director, shall be an order to pay an amount not exceeding the following:
(1) No civil penalty or forfeiture for a level one violation;
(2) One thousand dollars per each level two violation, up to an aggregate civil penalty or forfeiture of fifty thousand dollars per annum for multiple violations;
(3) Five thousand dollars per each level three violation, up to an aggregate civil penalty or forfeiture of two hundred thousand dollars per annum for multiple violations;
(4) Twenty thousand dollars per each level four violation, up to an aggregate civil penalty or forfeiture of one million dollars per annum for multiple violations;
(5) One million dollars per each level five violation, with no limit to civil penalties or forfeitures for multiple violations.
4. No civil penalty or forfeiture may be imposed against a person, unless the person has engaged in the act, practice, omission or course of business constituting the violation.
5. Any violation of the laws of this state relating to insurance in this chapter, chapter 354 and chapters 375 to 385, RSMo, which is not classified or does not authorize a specific range for a civil penalty or forfeiture for violations, shall be classified as a level one violation. In bringing an action to enforce a rule adopted by the director, unless the conduct that violates the rule also violates the enabling statute, the violation shall be classified as a level one violation and shall not be subject to any provision in this section regarding the enhancement of a civil penalty or forfeiture.
6. The civil penalties or forfeitures set forth in this section establish a maximum range. The court, or the director in administrative enforcement, shall consider all of the circumstances, including the nature of violations to determine whether, and to any extent, a civil penalty or forfeiture is justified.
7. In any enforcement proceeding, the court, or director in administrative enforcement, may enhance the civil penalty or forfeiture with a one-classification step increase under this section, if the violation was knowing. The court, or director in administrative enforcement, may enhance the civil penalty or forfeiture with a two-level increase if the violation was knowingly committed in conscious disregard of the law.
8. In any enforcement proceeding, the court, or director in administrative enforcement, may, after consideration of the factors specified in subsection 2 of section 374.046, enhance the civil penalty or forfeiture with a one-classification step increase under this section, if the violations resulted in actual financial loss to consumers.
9. In any enforcement proceeding, the court, or director in administrative enforcement, shall reduce the civil penalty or forfeiture on that person with up to a two-classification step reduction under this section, if prior to receiving notice of the violation from the department, the person detects the violation through a self-audit or internal compliance program reasonably designed to detect and prevent insurance law violations and immediately reports the violation to the director.
10. If more than one error is caused by a single act or omission in the use of data processing equipment and such errors are not known by the violator at the time the error occurs, then any such errors shall be regarded as a single violation under this section.
11. Any civil penalty or forfeiture recovered by the director shall be paid to the treasurer and then distributed to the public schools as required by Article IX, section 7 of the Missouri Constitution.
12. The penalties and forfeitures authorized by this section govern all actions and proceedings that are instituted on the basis of conduct occurring after August 28, 2006.
(L. 2006 H.B. 1837)
374.050. 1. The seal now used by said department shall be the seal of the office of the director of the insurance department, and the same may be renewed whenever necessary.
2. Every certificate or other paper executed by said director in pursuance of any authority conferred on him by law, and sealed with his seal of office, and all copies of papers in the office of said director, certified by him and authenticated by said seal, shall, in all cases, be evidence equally and in like manner as the originals, and shall have the same force and effect as the originals thereof would, in any suit or proceeding in any court of this state.
(RSMo 1939 § 5787)Prior revisions: 1929 § 5677; 1919 § 6088; 1909 § 6882
374.051. 1. Any applicant refused a license or the renewal of a license by order of the director under sections 374.755, 374.787, and 375.141, RSMo, may file a petition with the administrative hearing commission alleging that the director has refused the license. The administrative hearing commission shall conduct hearings and make findings of fact and conclusions of law in determining whether the applicant may be disqualified by statute. Notwithstanding section 621.120, RSMo, the director shall retain discretion in refusing a license or renewal and such discretion shall not transfer to the administrative hearing commission.
2. If a proceeding is instituted to revoke or suspend a license of any person under sections 374.755, 374.787, and 375.141, RSMo, the director shall refer the matter to the administrative hearing commission by directing the filing of a complaint. The administrative hearing commission shall conduct hearings and make findings of fact and conclusions of law in such cases. The director shall have the burden of proving cause for discipline. If cause is found, the administrative hearing commission shall submit its findings of fact and conclusions of law to the director, who may determine appropriate discipline.
3. Hearing procedures before the director or the administrative hearing commission and judicial review of the decisions and orders of the director and of the administrative hearing commission, and all other procedural matters under this chapter, shall be governed by the provisions of chapter 536, RSMo. Hearings before the administrative hearing commission shall also be governed by the provisions of chapter 621, RSMo.
(L. 2007 S.B. 66)
374.055. 1. Except as otherwise provided, any interested person aggrieved by any order of the director under the laws of this state relating to insurance in this chapter, chapter 354, RSMo, and chapters 375 to 385, RSMo, or a rule adopted by the director, or by any refusal or failure of the director to make an order pursuant to any of said provisions, shall be entitled to a hearing before the director in accordance with the provisions of chapter 536, RSMo. A final order issued by the director is subject to judicial review in accordance with the provisions of chapter 536, RSMo. However, any findings of fact or conclusions of law in any order regarding the actual costs of the investigation or proceedings under section 374.046, or the classification of any violation under section 374.049, shall be subject to de novo review.
2. A rule adopted by the director is subject to judicial review in accordance with the provisions of chapter 536, RSMo.
3. Notwithstanding any other provision of law to the contrary, no person or entity shall impose an accident response service fee on or from an insurance company, the driver or owner of a motor vehicle, or any other person. As used in this section, the term "accident response service fee" means a fee imposed for the response or investigation by a local law enforcement agency of a motor vehicle accident.
(L. 2007 S.B. 66)
374.060. 1. The director shall maintain his office in Jefferson City and shall keep the same open from eight a.m. to five p.m. every day except Saturdays, Sundays and public holidays. He shall be furnished with suitable rooms in the capitol or other state office building, which shall be furnished with a safe, furniture, stationery, printing and such other things as may be necessary for the transaction of the business of his office.
2. With the approval of the governor, the director may maintain branch offices in this state as may be needed to effectively discharge the duties of his office.
(RSMo 1939 § 5788, A. 1949 H.B. 2115, A.L. 1967 p. 516)Prior revisions: 1929 § 5678; 1919 § 6089; 1909 § 6883
374.070. 1. The office shall be a public office and the records shall be public records and shall at all times be open to the inspection of the public subject to such rules as the director shall make for their safekeeping; provided, however, that the work product of the director, the director's employees and agents, including but not limited to work papers of examinations of companies, work papers of investigations of companies, agents, brokers and insurance agencies and confidential communications to the department of insurance, shall not be considered public records except as the director may decide otherwise.
2. When requested, the director shall furnish certified copies of any paper, report, or documents on file in the director's office to any person requesting them, upon payment of the fees allowed by law.
3. Five years after the conclusion of the transactions to which they relate, the director is authorized to destroy or otherwise dispose of all correspondence, complaints, claim files, working papers of examinations of companies, examination reports of companies made by the insurance supervisory officials of states other than Missouri, rating files, void or obsolete or superseded rate filings and schedules, individual company rating experience data, applications, requisitions, and requests for licenses, all license cards and records, all expired bonds, all records of hearings, and all similar records, papers, documents, and memoranda now or hereafter in the possession of the director.
4. Ten years after the conclusion of the transactions to which they relate, the director is authorized to destroy or otherwise dispose of all foreign companies' and alien companies' annual statements, valuation reports, tax reports, and all similar records, papers, documents and memoranda now or hereafter in the possession of the director.
5. Disposal and destruction of records shall be in accordance with sections 109.200 to 109.310, RSMo.
(RSMo 1939 §§ 5788, 5793, A. 1949 H.B. 2115, A.L. 1953 p. 242, A.L. 1967 p. 516, A.L. 1999 S.B. 19 merged with S.B. 386)Prior revisions: 1929 §§ 5678, 5683; 1919 §§ 6089, 6094; 1909 §§ 6883, 6888
374.071. 1. The following records of the department are not public records and are not available for public examination under section 374.070:
(1) Any document or other material in any consumer complaint file maintained under section 374.085, including medical records, repair estimates, adjuster notes, insurance policy provisions, recordings or transcripts of witness interviews, and any other records regarding coverage, settlement, payment, or denial of claim asserted under an insurance policy;
(2) Any document or other material submitted by an insurer or producer under section 374.190, or any other inquiry, information request, or data call initiated by the department.
2. Any record that is not public under subsections 1 and 2 of this section is confidential and is not subject to disclosure, including discovery or subpoena, unless the subpoena is issued by the prosecuting attorney, attorney general, administrative hearing officer, or under the authority of any court. The director may only produce the documents or other material to another state or federal governmental agency or officer under a lawful request, subpoena, or formal discovery procedure. The documents or material may, in the discretion of the director, be made public once admitted as evidence in any administrative, civil, or criminal enforcement proceeding.
3. The director may release contents of any record that is not public under this section as part of an examination report under section 374.205, if the release is in the public interest. Notwithstanding any provision of subsections 1 and 2 of this section to the contrary, in all cases, the director may release an incident report record consisting of the date and immediate facts and circumstances surrounding the initial consumer report or complaint.
4. No waiver of any applicable privilege or claim of confidentiality regarding any document shall occur as a result of disclosure to the director or by the director in sharing documents with other state and federal regulatory agencies, the National Association of Insurance Commissioners, and its affiliates and subsidiaries, or state or federal law enforcement authorities, and the recipient of such document is bound by the provisions of this section as to the confidentiality of such document.
(L. 2005 H.B. 388)
374.075. 1. The director of the department of insurance may establish two or more divisions within the department. The director shall establish at least one division, to be known as the "Division of Consumer Affairs", which shall perform the functions of the consumer services section in addition to such other functions as may be assigned to it by the director.
2. Any division established by the director shall be considered as though it were transferred to the insurance department under a type I transfer under section 1 of the Reorganization Act of 1974, except that the advisory commission on insurance regulation, established in section 374.281, shall review the need for the division of consumer affairs to be transferred under a type III transfer and report its findings to the general assembly within one year after June 26, 1991.
3. All property, functions, duties and funds of the division of insurance as it existed under the department of economic development shall be transferred to the department of insurance. In addition, the property, functions, duties and funds formerly possessed, performed, assigned or appropriated to the department of economic development on behalf or for the benefit of the division of insurance shall be transferred to the department of insurance.
4. Wherever the laws, rules or regulations of this state make reference to the "division of insurance" or to the "insurance division", such references shall be deemed to refer to the department of insurance.
(L. 1991 H.B. 575)Effective 6-26-91
374.080. 1. The director may appoint a deputy, who shall be subject to removal at pleasure by the director, and who shall possess all the powers and perform all the duties attached by law to the office of director during a vacancy in the office, and during the absence, inability or suspension of his principal. The director shall be responsible for the acts of his deputy, who shall, before entering upon the duties of his office, take the oath and be bonded as required of the director in section 374.030. The deputy director shall assist the director in the administration of the department, and perform such duties and have such powers as the director may direct.
2. In the event there is an absence of the director and no deputy has been appointed, the governor shall appoint the acting director from among the division directors within the department.
(RSMo 1939 § 5783, A.L. 1967 p. 516, A.L. 1990 H.B. 1739, A.L. 1991 H.B. 575)Prior revisions: 1929 § 5673; 1919 § 6085; 1909 § 6880
Effective 6-26-91
374.085. 1. The division of consumer affairs of the department of insurance shall perform the following functions:
(1) The division shall receive complaints and inquiries from the general public concerning insurance companies, health services corporations and health maintenance organizations, their agents and employees;
(2) The division shall maintain records of each complaint received and the disposition of that complaint, indexed by type of complaint, company, and such other factors as the section deems appropriate;
(3) The division shall operate a statewide toll-free telephone service to receive complaints and inquiries, and shall publicize the existence of this service to the general public;
(4) The division shall investigate complaints received of unfair or unlawful acts under the insurance laws of this state and shall close the file on each investigation only when the director of the consumer services division is satisfied that the person or persons complained against have taken a fair and reasonable position or one which is legally correct;
(5) The division shall prepare such brochures and other documents as it deems appropriate to help inform the general public on such topics as the state's insurance laws, insurance practices, policy coverages and policy costs; and
(6) The division shall recommend changes to state statutes when it considers such statutes to adversely or unfairly affect the interests of the general public.
2. In performing the functions of this section, the consumer services division may be assisted by a legal adviser. The legal adviser shall be an attorney licensed to practice law in the state of Missouri and shall possess a knowledge of the state's insurance laws and regulations.
(L. 1990 H.B. 1739, A.L. 1991 H.B. 575)Effective 6-26-91
374.090. 1. The director shall appoint and employ an actuary, a chief market conduct examiner and a chief financial examiner, who shall be subject to removal at the pleasure of the director. The director may contract with persons to assist the actuary or to provide actuarial services subject to appropriation by the general assembly.
2. The actuary shall have had at least five years' experience in actuarial work, the chief market conduct examiner shall have at least five years in insurance examination work as defined by the NAIC market conduct examiners' handbook in effect on August 28, 1990, and the chief financial examiner shall have had at least five years' experience in financial examination work.
3. The actuary and examiners shall not be or become interested in any insurance company other than as a policyholder.
4. The actuary and the examiners each shall file bond as required by the director, which shall not exceed the sum of ten thousand dollars.
(RSMo 1939 § 5784, A. 1949 H.B. 2115, A.L. 1990 H.B. 1739)Prior revision: 1929 § 5674
374.100. 1. The actuary shall perform those duties usually performed by actuaries and such other duties in connection with the department as the director may direct.
2. All fees allowed or paid to the actuary as provided by law shall be paid to the director of revenue and shall be deposited to the credit of the insurance department fund.
(RSMo 1939 §§ 5784, 5786, A. 1949 H.B. 2115)Prior revisions: 1929 §§ 5674, 5676; 1919 § 6087; 1909 § 6881
374.110. 1. The director of insurance, through the chief examiner, may examine into the affairs and good faith of any person who is engaged in, or is claiming or advertising that he is engaged in, organizing or receiving subscriptions for or disposing of stock of, or in any manner aiding or taking part in the formation of or business of an insurance corporation, association or organization and the chief examiner shall conduct or assist in conducting the examination of insurance companies, associations and organizations and reciprocal or interinsurance exchanges as required by law, and do such other things pertaining to the department as the director may direct.
2. The director may also employ one or more expert actuaries or examiners to assist the chief examiner in making such examinations.
3. The fees and expenses in all cases to be reasonable and to be paid by the company, association, organization or reciprocal or interinsurance exchange being examined upon accounts approved by the director.
(RSMo 1939 § 5784, A. 1949 H.B. 2115)Prior revision: 1929 § 5674
374.115. Examiners appointed or employed by the director of the department of insurance shall be compensated according to the applicable levels established and published by the National Association of Insurance Commissioners.
(L. 1989 S.B. 333 § 1)
374.120. 1. The director shall appoint and employ such clerks and clerical and other help which are necessary for a proper dispatch of the business of the department of insurance at salaries as now or hereafter provided by law, and may employ such actuarial work to be done as may be necessary, all of which expense shall be paid as provided for by section 374.160, out of the amount appropriated by law from the fees collected by the department of insurance.
2. The director shall appoint and employ legal counsel regarding the enforcing of the insurance laws of the state; provided, however, that with respect to criminal prosecutions, the attorney general shall be the legal adviser to the director. All counsel employed by the legal section shall be attorneys licensed to practice law in the state of Missouri and the general counsel shall be subject to removal at the pleasure of the director. In addition, the general counsel shall have had at least two years of experience in the areas of insurance law, insurance regulation or insurance litigation, or any combination thereof. The general counsel may receive an annual salary of up to one thousand dollars less than the annual salary paid the director. The director may assign legal counsel to specific divisions established pursuant to section 374.075. Legal counsel may act as hearing officers at any hearing before the insurance department, but may not act as a hearing officer in any contested case brought to the director from a division to which legal counsel was assigned.
3. The director may also employ suitable persons to make examinations as to the solvency or market conduct of companies when he deems it necessary.
4. The director shall also employ a reinsurance analyst to assist the department in carrying out its responsibilities regarding reinsurers as are provided for by law. The reinsurance analyst shall have knowledge of the state's insurance laws and regulations, shall have a degree in accounting, and shall be able to meet the requirements of an Associate in Reinsurance of the American Institute of Property and Liability Underwriters within two years of appointment, or comparable standards as provided for by regulation, and have at least three years' experience in insurance or reinsurance matters.
5. The director shall not employ any person in any capacity who is an officer, agent or employee of any insurance company or association.
(RSMo 1939 § 5788, A. 1949 H.B. 2115, A.L. 1990 H.B. 1739, A.L. 1991 H.B. 575)Prior revisions: 1929 § 5678; 1919 § 6089; 1909 § 6883
Effective 6-26-91
(1956) Counsel employed by the director must be paid in the same way as other expenses of the insurance division and cannot be paid from funds escheated to the state under § 379.395. Jacobs v. Leggett (Mo.), 295 S.W.2d 825.
(1962) Attorneys' fees, arising under 1930 agreement whereby director had agreed to pay attorneys out of unreturned excess premiums which attorneys might be successful in recovering from companies, could not be allowed as department expense payable out of current appropriations and state was not liable for fees by estoppel where method of payment provided in contract was invalid. State ex rel. Johnson v. Leggett (Mo.), 359 S.W.2d 790.
374.130. The director may designate one of the clerks of the insurance department as chief clerk, who shall possess the qualifications of the director, and shall, subject to the director and his deputy, have charge of the clerical and detail work of the department, and the employees thereof. In the absence or inability of both the director and deputy or in case of a vacancy in both of said offices, the chief clerk shall have and exercise the powers of the director. Chief clerk shall serve during the pleasure of the director, and shall perform such other duties as the director may direct.
(RSMo 1939 § 5785)Prior revisions: 1929 § 5675; 1919 § 6086
374.150. 1. All fees due the state under the provisions of the insurance laws of this state shall be paid to the director of revenue and deposited in the state treasury to the credit of the insurance dedicated fund unless otherwise provided for in subsection 2 of this section.
2. There is hereby established in the state treasury a special fund to be known as the "Insurance Dedicated Fund". The fund shall be subject to appropriation of the general assembly and shall be devoted solely to the payment of expenditures incurred by the department attributable to duties performed by the department for the regulation of the business of insurance, regulation of health maintenance organizations and the operation of the division of consumer affairs as required by law which are not paid for by another source of funds. Other provisions of law to the contrary notwithstanding, beginning on January 1, 1991, all fees charged under any provision of chapter 325, 354, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384 or 385, RSMo, due the state shall be paid into this fund. The state treasurer shall invest moneys in this fund in the same manner as other state funds and any interest or earnings on such moneys shall be credited to the insurance dedicated fund. The provisions of section 33.080, RSMo, notwithstanding, moneys in the fund shall not lapse, be transferred to or placed to the credit of the general revenue fund unless and then only to the extent to which the unencumbered balance at the close of the biennium year exceeds two times the total amount appropriated, paid, or transferred to the fund during such fiscal year.
(RSMo 1939 § 5786, A.L. 1945 p. 1018, A. 1949 H.B. 2115, A.L. 1990 H.B. 1739, A.L. 1991 H.B. 575, A.L. 2003 S.B. 675, A.L. 2007 S.B. 66)Prior revisions: 1929 § 5676; 1919 § 6087; 1909 § 6881
374.160. 1. The expenses of examinations, valuations or proceedings against any company, and for dissolving or settling the affairs of companies are to be paid by the company, or as provided by law. The state shall not be responsible in any manner for the payment of any such expenses, or any charges connected therewith.
2. At the request of the director, every domestic insurance company or health maintenance organization subject to an order of conservation, rehabilitation, or liquidation shall reimburse the insurance dedicated fund for administrative services rendered by state employees to the company. Reimbursement shall include that portion of the employee's salary, state benefits, and expenses that specifically relates to the services rendered on behalf of the company.
3. All other expenses of the department of insurance, financial institutions and professional registration now or hereafter incurred and unpaid, or that may be hereafter incurred, including the salaries of the director and deputy director, shall be paid out of the state treasury in the manner provided by law.
4. The director shall assess the expenses of any examination against the company examined and shall order that the examination expenses be paid into the insurance examiners fund created by section 374.162. This assessment shall include the costs of compensation, including benefits, for the examiners, analysts, actuaries, and attorneys directly contributing to the examination of the company, any reasonable travel, lodging, and meal expenses related to an on-site examination, and other expenses related to the examination of the company, including an allocation for examiners' office space, supplies, and equipment, but not expenses associated with attending a course, seminar, or meeting, unless solely related to the examination of the company assessed. The director shall pay from the insurance examiners fund the compensation of insurance examiners, analysts, actuaries, and attorneys, including standard benefits afforded to state employees, for performance of any such examination and other expenses covered in the assessment. The general assembly shall annually provide appropriations sufficient to distribute all receipts into the insurance examiners fund. The provisions of section 33.080, RSMo, relating to the transfer of unexpended balances to the general revenue fund shall not apply to the insurance examiners fund.
5. If any company shall refuse to pay the expenses of any examination, valuation or proceeding assessed by the director pursuant to this section, the company shall be liable for double the amount of such expenses and all costs of collection, including attorney's fees. The company shall not be entitled to a credit, pursuant to section 148.400, RSMo, for any fees, expenses or costs ordered pursuant to this subsection other than in the amount of the expenses originally assessed by the director. All amounts collected pursuant to this subsection shall be credited to the insurance examiners fund.
(RSMo 1939 § 5789, A.L. 1945 p. 1018, A.L. 1980 H.B. 1266, A.L. 1991 H.B. 385, et al., A.L. 2007 S.B. 66)Prior revisions: 1929 § 5679; 1919 § 6090; 1909 § 6884
(1962) Attorneys' fees, arising under 1930 agreement whereby director had agreed to pay attorneys out of unreturned excess premiums which attorneys might be successful in recovering from companies, could not be allowed as department expense payable out of current appropriations and state was not liable for fees by estoppel where method of payment provided in contract was invalid. State ex rel. Johnson v. Leggett (Mo.), 359 S.W.2d 790.
374.162. 1. There is hereby established a fund for the examination expenses to be paid pursuant to section 374.160, to be known as the "Insurance Examiners Fund". There shall be an amount assessed against all insurers, health services corporations and health maintenance organizations which are engaged in the business of insurance within this state in order to provide initial funding for the insurance examiners fund. The assessment shall be made between August 28, 1991, and December 31, 1991, in the total amount of four hundred thousand dollars. The assessment of each such insurer, health services corporation and health maintenance organization shall be proportionate to the amount of premiums or enrollment fees received in this state by the insurer, health services corporation or health maintenance organization during calendar year 1990, is to the total amount of premiums and enrollment fees received in this state by all such entities during calendar year 1990.
2. The director may make an assessment between August 28, 1993, and June 30, 1994, of each insurer, health services corporation and health maintenance organization to provide a minimum balance in the insurance examiners fund. The total amount of all assessments made pursuant to this subsection shall not exceed four hundred thousand dollars. Such assessments shall be proportionate to the amount of premiums or enrollment fees received by such insurer, health services corporation, or health maintenance organization during the calendar year 1992 to the total amount of premiums and enrollment fees received in this state by all such entities during calendar year 1992, except that the total amount of all assessments on each insurer, health services corporation or health maintenance organization shall be at least two hundred fifty dollars and shall not exceed two thousand dollars.
(L. 1991 H.B. 385, et al. § 1, A.L. 1993 H.B. 709)
374.170. The director of the insurance department shall cause to be prepared, and furnished to every insurance company doing business in this state, forms of the statements required by him from said companies, and he may make such changes and additions, from time to time, in the same, and in any statements required, as shall seem to him best adapted to elicit from said companies a true exhibit of their condition and management.
(RSMo 1939 § 5791, A.L. 1987 H.B. 700)Prior revisions: 1929 § 5681; 1919 § 6092; 1909 § 6886
Effective 7-1-87
374.180. 1. The director of the department of insurance shall prepare the following information to be included in the biennial report of the director of the department of economic development:
(1) A brief review of the department during the period covered by the report, including a verified statement of the various sums received and disbursed by him, and from and to whom, and for what purposes;
(2) Name, address, capital stock, in case of companies having a capital stock, resources, insurance in force, and the amount and nature of collateral deposited by each insurance company or association authorized or licensed to do business in this state;
(3) A tabular statement, and synopsis of the annual statements, as accepted by the director, of all insurance companies doing business in this state;
(4) Such other matters as in his opinion may be for the benefit of the public and such recommendations as he shall deem proper in regard to the insurance laws of this state.
2. No more than two thousand copies of such report shall be published by order of the director, at the expense of the department.
3. The director shall make such additional reports as shall be required by the governor.
(RSMo 1939 §§ 5792, 5797, 15005, A. 1949 H.B. 2115)Prior revisions: 1929 §§ 5682, 5687, 13812; 1919 §§ 6093, 6098; 1909 §§ 6887, 6892
374.182. The department shall submit an organizational plan in the same manner as is required of departments under subsection (2) of section 1 of the Reorganization Act of 1974; provided, however, that the compensation levels to be reported shall include those of the director, the deputy director, the assistant director for policies and licenses, the assistant director for consumer services and the general counsel.
(L. 1990 H.B. 1739 § 4)
374.184. 1. The director of the department of insurance shall prescribe by rule, after due consultation with providers of health care or treatment and their respective licensing boards, accident and sickness insurers, health services corporations and health maintenance organizations, and after a public hearing, uniform claim forms for reporting by health care providers. Such prescribed forms shall include but need not be limited to information regarding the medical diagnosis, treatment and prognosis of the patient, together with the details of charges incident to the providing of such care, treatment or services, sufficient for the purpose of meeting the proof requirements of an accident and sickness insurance or hospital, medical or dental services contract. Such prescribed forms shall be based upon the UB-82 form, with respect to hospital claims, and the HCFA 1500 form, with respect to physician claims, as such forms are modified or amended from time to time by the National Uniform Billing Committee or the federal Health Care Financing Administration.
2. The adoption of any uniform claim forms by the director pursuant to this section shall not preclude an insurer, health services corporation, or health maintenance organization from requesting any necessary additional information in connection with a claims investigation from the claimant, provider of health care or treatment, or certifier of coverage. The provisions of this section shall not be deemed or construed to apply to electronic claims submission. Insurers and providers may by contract provide for modifications to the uniform billing document where both insurers and providers feel that such modifications streamline claims processing procedures relating to the claims of the insurer involved in such contract modification. However, a refusal by the provider to agree to modification of the uniform billing format shall not be used by the insurer as grounds for refusing to enter into a contract with the provider for reimbursement or payment for health services rendered to an insured of the insurer.
3. Rules adopted or promulgated pursuant to this act* shall be subject to notice and hearing as provided in chapter 536, RSMo. The regulations so adopted shall specify an effective date, which shall not be less than one hundred eighty days after the date of adoption, after which no accident and sickness insurer, health services corporation or health maintenance organization shall require providers of health care or treatment to complete forms differing from those prescribed by the director pursuant to this section, and after which no health care provider shall submit claims except upon such prescribed forms; provided that the provisions of this section shall not preclude the use by any insurer, health services corporation or health maintenance organization of the UB-82 form or the HCFA 1500 form.
(L. 1992 S.B. 796 § 13)*"This act" (S.B. 796, 1992) contains numerous sections. Consult Disposition of Sections table for definitive listing.
374.185. 1. The director may cooperate, coordinate, and consult with other members of the National Association of Insurance Commissioners, the commissioner of securities, state securities regulators, the division of finance, the division of credit unions, the attorney general, federal banking and securities regulators, the National Association of Securities Dealers (NASD), the United States Department of Justice, the Commodity Futures Trading Commission, and the Federal Trade Commission to effectuate greater uniformity in insurance and financial services regulation among state and federal governments, and self-regulatory organizations. The director may share records with any aforesaid entity, except that any record that is confidential, privileged, or otherwise protected from disclosure by law shall not be disclosed unless such entity agrees in writing prior to receiving such record to provide it the same protection. No waiver of any applicable privilege or claim of confidentiality regarding any record shall occur as the result of any disclosure.
2. In cooperating, coordinating, consulting, and sharing records and information under this section and in acting by rule, order, or waiver under the laws relating to insurance, the director shall, at the discretion of the director, take into consideration in carrying out the public interest the following general policies:
(1) Maximizing effectiveness of regulation for the protection of insurance consumers;
(2) Maximizing uniformity in regulatory standards; and
(3) Minimizing burdens on the business of insurance, without adversely affecting essentials of consumer protection.
3. The cooperation, coordination, consultation, and sharing of records and information authorized by this section includes:
(1) Establishing or employing one or more designees as a central electronic depository for licensing and rate and form filings with the director and for records required or allowed to be maintained;
(2) Encouraging insurance companies and producers to implement electronic filing through a central electronic depository;
(3) Developing and maintaining uniform forms;
(4) Conducting joint market conduct examinations and other investigations through collaboration and cooperation with other insurance regulators;
(5) Holding joint administrative hearings;
(6) Instituting and prosecuting joint civil or administrative enforcement proceedings;
(7) Sharing and exchanging personnel;
(8) Coordinating licensing under section 375.014, RSMo;
(9) Formulating rules, statements of policy, guidelines, forms, no action determinations, and bulletins; and
(10) Formulating common systems and procedures.
(L. 2007 S.B. 66)
374.190. 1. The director shall examine and inquire into all violations of the insurance laws of the state, and inquire into and investigate the business of insurance transacted in this state by any insurance agent, broker, agency or insurance company.
2. He or any of his duly appointed agents may compel the attendance before him, and may examine, under oath, the directors, officers, agents, employees, solicitors, attorneys or any other person, in reference to the condition, affairs, management of the business, or any matters relating thereto. He may administer oaths or affirmations, and shall have power to summon and compel the attendance of witnesses, and to require and compel the production of records, books, papers, contracts or other documents, if necessary.
3. The director may make and conduct the investigation in person, or he may appoint one or more persons to make and conduct the same for him. If made by another than the director in person, the person duly appointed by the director shall have the same powers as above granted to the director. A certificate of appointment, under the official seal of the director, shall be sufficient authority and evidence thereof for the person or persons to act. For the purpose of making the investigations, or having the same made, the director may employ the necessary clerical, actuarial and other assistance.
(RSMo 1939 § 5794, A. 1949 H.B. 2115, A.L. 1967 p. 516, A.L. 1992 H.B. 1574)Prior revisions: 1929 § 5684; 1919 § 6095; 1909 § 6889
374.194. 1. Notwithstanding any other provision of law to the contrary, and except as provided in this section, any person or other entity which provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department of insurance, unless the person or other entity shows that while providing such services it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government.
2. A person or entity may show that it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government, by providing to the director of the department of insurance the appropriate certificate, license or other document issued by the other governmental agency which permits or qualifies it to provide those services.
3. Any person or entity which is unable to show under subsection 2 of this section that it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government, shall submit to an examination by the director of the department of insurance to determine the organization and solvency of the person or the entity, and to determine whether or not such person or entity complies with the applicable provisions of chapters 374 to 385, RSMo.
4. Any person or entity unable to show that it is subject to the jurisdiction of another agency of this state, any subdivision thereof, or the federal government, shall be subject to all appropriate provisions of chapters 374 to 385, RSMo, regarding the conduct of its business.
5. Any production agency or administrator which advertises, sells, transacts or administers the coverage of this state described in subsection 1 of this section and which is required to submit to an examination by the director of the department of insurance under subsection 3 of this section, if such coverage is not fully insured or otherwise fully covered by an admitted life of disability insurer, nonprofit health services plan, or nonprofit health care plan shall advise every purchaser, prospective purchaser, and covered person of such lack of insurance or other coverage. Any administrator which advertises or administers the coverage in this state described in subsection 1 of this section and which is required to submit to an examination by the director of the department of insurance under subsection 3 of this section shall advise any production agency of the elements of the coverage, including the amount of stop-loss insurance in effect.
(L. 1991 H.B. 385, et al. § 113)
374.202. 1. The purpose of sections 374.202 to 374.207 is to provide an effective and efficient system for examining the activities, operations, financial or market conduct, condition and affairs of all persons transacting the business of insurance in this state and all persons otherwise subject to the jurisdiction of the director. The provisions of sections 374.202 to 374.207 are intended to enable the director to adopt a flexible system of examinations which directs resources as the director may deem appropriate and necessary for the administration of the insurance related laws of this state.
2. As used in sections 374.202 to 374.207, the following terms mean:
(1) "Company", any person engaging in or proposing or attempting to engage in any transaction or kind of insurance or surety business and any person or group of persons who may otherwise be subject to the administrative, regulatory or taxing authority of the director;
(2) "Department", the department of insurance of this state;
(3) "Director", the director of the department of insurance of this state;
(4) "Examiner", any individual or firm having been authorized by the director to conduct an examination under sections 374.202 to 374.207;
(5) "Insurer" has the same meaning as insurer under sections 375.1150 to 375.1246, RSMo;
(6) "Person", any individual, aggregation of individuals, trust, association, partnership or corporation, or any affiliate thereof.
(L. 1992 H.B. 1574)
374.205. 1. (1) The director or any of the director's examiners may conduct an examination pursuant to sections 374.202 to 374.207 of any company as often as the director in his or her sole discretion deems appropriate, but shall, at a minimum, conduct a financial examination of every insurer licensed in this state at least once every five years. In scheduling and determining the nature, scope and frequency of examinations, the director may consider such matters as the results of financial statement analyses and ratios, changes in management or ownership, actuarial opinions, reports of independent certified public accountants, consumer complaints, and other criteria as set forth in the Examiners' Handbook adopted by the National Association of Insurance Commissioners and in effect when the director exercises discretion pursuant to this section.
(2) For purposes of completing an examination of any company pursuant to sections 374.202 to 374.207, the director may examine or investigate any person, or the business of any person, insofar as such examination or investigation is, in the sole discretion of the director, necessary or material to the examination of the company.
(3) In lieu of a financial examination pursuant to section 374.207 of any foreign or alien insurer licensed in this state, the director may accept a financial examination report on the company as prepared by the insurance department or other appropriate agency for the company's state of domicile or port-of-entry state until January 1, 1994. After January 1, 1994, such reports may only be accepted if such insurance department or other appropriate agency was at the time of the examination accredited pursuant to the National Association of Insurance Commissioners' Financial Regulation Standards and Accreditation Program or the examination is performed under the supervision of an accredited insurance department or other appropriate agency or with the participation of one or more examiners who are employed by such an accredited state insurance department or other appropriate agency and who, after a review of the examination workpapers and report, state under oath that the examination was performed in a manner consistent with the standards and procedures required by their insurance department or other appropriate agency.
2. (1) Upon determining that an examination should be conducted, the director or the director's designee shall issue an examination warrant appointing one or more examiners to perform the examination and instructing them as to the scope of the examination. In conducting the examination, the examiner shall observe those guidelines and procedures set forth in the Examiners' Handbook adopted by the National Association of Insurance Commissioners. The director may also employ such other guidelines or procedures as the director may deem appropriate.
(2) Every company or person from whom information is sought, its officers, directors and agents shall provide to the examiners appointed pursuant to subdivision (1) of this subsection timely, convenient and free access at all reasonable hours at its offices to all books, records, accounts, papers, documents and any or all computer or other recordings relating to the property, assets, business and affairs of the company being examined. The company or person being examined shall provide within ten calendar days any record requested by an examiner during a market conduct examination, unless such company or person demonstrates to the satisfaction of the director that the requested record cannot be provided within ten calendar days of the request. All policy records for each policy issued shall be maintained for the duration of the current policy term plus two calendar years and all claim files shall be maintained for the calendar year in which the claim is closed plus three calendar years. The officers, directors, employees and agents of the company or person shall facilitate the examination and aid in the examination so far as it is in their power to do so. The refusal of any company, by its officers, directors, employees or agents, to submit to examination or to comply with any reasonable written request of the examiners shall be grounds for suspension or refusal of, or nonrenewal of, any license or authority held by the company to engage in an insurance or other business subject to the director's jurisdiction. Any such proceeding for suspension, revocation or refusal of any license or authority shall be conducted pursuant to section 374.046.
(3) The director or any of the director's examiners may issue subpoenas to administer oaths and to examine under oath any person as to any matter pertinent to the examination. Upon the failure or refusal of any person to obey a subpoena, the director may petition a court of competent jurisdiction, and upon proper showing, the court may enter an order compelling the witness to appear and testify or produce documentary evidence. Failure to obey the court order shall be punishable as contempt of court. Such subpoenas may also be enforced pursuant to the provisions of sections 375.881 and 375.1162, RSMo.
(4) When making an examination pursuant to sections 374.202 to 374.207, the director may retain attorneys, appraisers, independent actuaries, independent certified public accountants or other professionals and specialists as examiners, the cost of which shall be borne directly by the company which is the subject of the examination.
(5) The provisions of sections 374.202 to 374.207 shall not be construed to limit the director's authority to terminate or suspend any examination in order to pursue other legal or regulatory action pursuant to the insurance laws of this state. Findings of fact and conclusions made pursuant to any examination shall be prima facie evidence in any legal or regulatory action.
(6) Nothing contained in sections 374.202 to 374.207 shall be construed to limit the director's authority to use and, if appropriate, to make public any final or preliminary examination report, any examiner or company workpapers or other documents, or any other information discovered or developed during the course of any examination in the furtherance of any legal or regulatory action which the director may, in his or her sole discretion, deem appropriate.
3. (1) All examination reports shall be comprised of only facts appearing upon the books, records, or other documents of the company, its agents or other persons examined, or as ascertained from the testimony of its officers or agents or other persons examined concerning its affairs, and such conclusions and recommendations as the examiners find reasonably warranted from the facts.
(2) No later than sixty days following completion of the examination, the examiner in charge shall file with the department a verified written report of examination under oath. Upon receipt of the verified report, the department shall transmit the report to the company examined, together with a notice which shall afford the company examined a reasonable opportunity of not more than thirty days to make a written submission or rebuttal with respect to any matters contained in the examination report.
(3) Within thirty days of the end of the period allowed for the receipt of written submissions or rebuttals, the director shall fully consider and review the report, together with any written submissions or rebuttals and any relevant portions of the examiner's workpapers and either initiate legal action or enter an order:
(a) Adopting the examination report as filed or with modification or corrections. If the examination report reveals that the company is operating in violation of any law, regulation or prior order of the director, the director may order the company to take any action the director considers necessary and appropriate to cure such violation;
(b) Rejecting the examination report with directions to the examiners to reopen the examination for purposes of obtaining additional data, documentation or information, and refiling pursuant to subsection 1 of this section;
(c) Calling for an investigatory hearing with no less than twenty days' notice to the company for purposes of obtaining additional documentation, data, information and testimony; or
(d) Calling for such regulatory action as the director deems appropriate, provided that this order shall be a confidential internal order directing the department to take certain action.
(4) All orders entered pursuant to paragraph (a) of subdivision (3) of this subsection shall be accompanied by findings and conclusions resulting from the director's consideration and review of the examination report, relevant examiner workpapers and any written submissions or rebuttals. Any such order shall be considered a final administrative decision and may be appealed pursuant to section 536.150, RSMo, and shall be served upon the company by certified mail, together with a copy of the adopted examination report. Within thirty days of the issuance of the adopted report, the company shall file affidavits executed by each of its directors stating under oath that they have received a copy of the adopted report and related orders. Any hearing conducted pursuant to paragraph (c) of subdivision (3) of this subsection by the director or authorized representative shall be conducted as a nonadversarial confidential investigatory proceeding as necessary for the resolution of any inconsistencies, discrepancies or disputed issues apparent upon the face of the filed examination report or raised by or as a result of the director's review of relevant workpapers or by the written submission or rebuttal of the company. Within twenty days of the conclusion of any such hearing, the director shall enter an order pursuant to paragraph (a) of subdivision (3) of this subsection. In conducting a hearing pursuant to paragraph (c) of subdivision (3) of this subsection:
(a) The director shall not appoint an examiner as an authorized representative to conduct the hearing. The hearing shall proceed expeditiously with discovery by the company limited to the examiner's workpapers which tend to substantiate any assertions set forth in any written submission or rebuttal. The director or his or her representative may issue subpoenas for the attendance of any witnesses or the production of any documents deemed relevant to the investigation whether under the control of the department, the company or other persons. The documents produced shall be included in the record, and testimony taken by the director or his or her representative shall be under oath and preserved for the record. The provisions of this section shall not require the department to disclose any information or records which would indicate or show the existence of any investigation or activity of a criminal justice agency; and
(b) The hearing shall proceed with the director or his or her representative posing questions to the persons subpoenaed. Thereafter, the company and the department may present testimony relevant to the investigation. Cross-examination shall be conducted only by the director or the director's representative. The company and the department shall be permitted to make closing statements and may be represented by counsel of their choice.
(5) Upon the adoption of the examination report pursuant to paragraph (a) of subdivision (3) of this subsection, the director shall continue to hold the content of the examination report as private and confidential information for a period of ten days except to the extent provided in this subdivision. Thereafter, the director may open the report for public inspection so long as no court of competent jurisdiction has stayed its publication. Nothing contained in the insurance laws of this state shall prevent or be construed as prohibiting the director from disclosing the content of an examination report, preliminary examination report or results, or any matter relating thereto, to the insurance department of this or any other state or country, or to law enforcement officials of this or any other state or agency of the federal government at any time, so long as such agency or office receiving the report or matters relating thereto agrees in writing to hold it confidential and in a manner consistent with this section. In the event the director determines that legal or regulatory action is appropriate as a result of any examination, he or she may initiate any proceedings or actions as provided by law.
4. All working papers, recorded information, documents and copies thereof produced by, obtained by or disclosed to the director or any person in the course of an examination made pursuant to this section shall be given confidential treatment and are not subject to subpoena and may not be made public by the director or any other person, except to the extent provided in subdivision (5) of subsection 3 of this section. Access may also be granted to the National Association of Insurance Commissioners. Such parties shall agree in writing prior to receiving the information to provide to it the same confidential treatment as required by this section, unless the prior written consent of the company to which it pertains has been obtained.
(L. 1992 H.B. 1574, A.L. 1997 H.B. 626 merged with H.B. 793, A.L. 1999 S.B. 19 merged with S.B. 386)
374.207. 1. No examiner may be appointed by the director if such examiner, either directly or indirectly, has a conflict of interest or is affiliated with the management of or owns a pecuniary interest in any person subject to examination under sections 374.202 to 374.207. This subsection shall not be construed to automatically preclude an examiner from being:
(1) A policyholder or claimant under an insurance policy;
(2) A grantor of a mortgage or similar instrument on the examiner's residence to a regulated entity if done under customary terms and in the ordinary course of business;
(3) An investment owner in shares of regulated diversified investment companies; or
(4) A settlor or beneficiary of a blind trust into which any otherwise impermissible holdings have been placed.
Notwithstanding the requirement of this subsection, the director may retain from time to time, on an individual basis, qualified actuaries, certified public accountants, or other similar individuals who are independently practicing their professions, even though said persons may from time to time be similarly employed or retained by persons subject to examination under sections 374.202 to 374.207.
2. Expenses and costs of examinations shall be paid as set forth in section 374.160.
3. The director, the director's authorized representatives or any examiner appointed by the director shall have such official immunity as exists at common law.
(L. 1992 H.B. 1574)
374.208. The director shall study and recommend to the general assembly changes to avoid unnecessary duplication of market conduct activities and to implement uniform processes and procedures for market analysis and market conduct examinations which will more effectively utilize resources to protect insurance consumers. The study shall be completed and recommendations provided by January 1, 2008.
(L. 2007 S.B. 66)
374.210. 1. It is unlawful for any person in any investigation, examination, inquiry, or other proceeding under this chapter, chapter 354, RSMo, and chapters 375 to 385, RSMo, to:
(1) Knowingly make or cause to be made a false statement upon oath or affirmation or in any record that is submitted to the director or used in any proceeding under this chapter, chapter 354, RSMo, and chapters 375 to 385, RSMo; or
(2) Make any false certificate or entry or memorandum upon any of the books or papers of any insurance company, or upon any statement or exhibit offered, filed or offered to be filed in the department, or used in the course of any examination, inquiry, or investigation under this chapter, chapter 354, RSMo, and chapters 375 to 385, RSMo.
2. If a person does not appear or refuses to testify, file a statement, produce records, or otherwise does not obey a subpoena as required by the director, the director may apply to the circuit court of any county of the state or any city not within a county, or a court of another state to enforce compliance. The court may:
(1) Hold the person in contempt;
(2) Order the person to appear before the director;
(3) Order the person to testify about the matter under investigation or in question;
(4) Order the production of records;
(5) Grant injunctive relief;
(6) Impose a civil penalty of up to fifty thousand dollars for each violation; and
(7) Grant any other necessary or appropriate relief.
The director may also suspend, revoke or refuse any license or certificate of authority issued by the director to any person who does not appear or refuses to testify, file a statement, produce records, or does not obey a subpoena.
3. This section does not preclude a person from applying to the circuit court of any county of the state or any city not within a county for relief from a request to appear, testify, file a statement, produce records, or obey a subpoena.
4. A person is not excused from attending, testifying, filing a statement, producing a record or other evidence, or obeying a subpoena of the director under an action or proceeding instituted by the director on the grounds that the required testimony, statement, record, or other evidence, directly or indirectly, may tend to incriminate the individual or subject the individual to a criminal fine, penalty, or forfeiture. If the person refuses to testify, file a statement, or produce a record or other evidence on the basis of the individual's privilege against self-incrimination, the director may apply to the circuit court of any county of the state or any city not within a county to compel the testimony, the filing of the statement, the production of the record, or the giving of other evidence. The testimony, record, or other evidence compelled under such an order may not be used as evidence against the person in a criminal case, except in a prosecution for perjury or contempt or otherwise failing to comply with the order.
5. If the director determines that a person has engaged, is engaging in, or has taken a substantial step toward engaging in an act, practice or course of business constituting a violation of this section, or a rule adopted or order issued pursuant thereto, or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, the director may issue such administrative orders as authorized under section 374.046. A violation of subsection 1 of this section is a level four violation under section 374.049. The director may also suspend or revoke the license or certificate of authority of such person for any willful violation.
6. If the director believes that a person has engaged, is engaging in, or has taken a substantial step toward engaging in an act, practice or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, the director may maintain a civil action for relief authorized under section 374.048. A violation of subsection 1 of this section is a level four violation under section 374.049.
7. Any person who knowingly engages in any act, practice, omission, or course of business in violation of subsection 1 of this section is guilty of a class D felony. If the offender holds a license or certificate of authority under the insurance laws of this state, the court imposing sentence shall order the department to revoke such license or certificate of authority.
8. The director may refer such evidence as is available concerning violations of this section to the proper prosecuting attorney, who with or without a criminal reference, or the attorney general under section 27.030, RSMo, may institute the appropriate criminal proceedings.
9. Nothing in this section shall limit the power of the state to punish any person for any conduct that constitutes a crime under any other state statute.
(RSMo 1939 § 5794, A. 1949 H.B. 2115, A.L. 2007 S.B. 66)Prior revisions: 1929 § 5684; 1919 § 6095; 1909 § 6889
374.215. 1. If any insurance company or other entity regulated by the director doing business in this state fails to timely make and file any statutorily required report or statement, the department shall notify such company or entity of such failure by first class mail. Any company or entity notified by the department pursuant to this section shall file such report or statement within fifteen days of receiving notification. After the expiration of such fifteen days, each day in which the company or entity fails to file such report or statement is a separate violation of this section.
2. If the director determines that a person has engaged, is engaging in, or has taken a substantial step toward engaging in an act, practice or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, the director may issue such administrative orders as authorized under section 374.046. A violation of this section is a level two violation under section 374.049. The director may also suspend or revoke the certificate of authority of such person for any willful violation.
3. If the director believes that a person has engaged, is engaging in, or has taken a substantial step toward engaging in an act, practice or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, or that a person has materially aided or is materially aiding an act, practice, omission, or course of business constituting a violation of this section or a rule adopted or order issued pursuant thereto, the director may maintain a civil action for relief authorized under section 374.048. A violation of this section is a level two violation under section 374.049.
(L. 1989 S.B. 333, A.L. 2007 S.B. 66)
374.216. 1. A person commits the crime of filing a false insurance statement if he prepares, makes, submits or files a financial report or statement with the department of insurance with the purpose to misrepresent the financial condition of the company in whose behalf such report or statement is prepared, made, submitted or filed. The crime shall require no mental state other than that specifically provided herein.
2. The crime of filing a false insurance statement is a class C felony.
(L. 1991 H.B. 385, et al. § 111)
374.217. 1. The director or any other employee of the department of insurance shall not enter into any covenant not to sue or any agreement to defer, refrain or desist from instituting or asserting against any officer or director of any insurer or any other person or entity regulated by the department of insurance, any claim, demand, action or suit, either administrative or judicial, for injuries, damages or penalties to the state or any person or property.
2. Any covenant or agreement entered into in derogation of subsection 1 of this section, either before or after August 28, 1991, shall be deemed to be in violation of the public policy of this state that the general assembly shall by law provide adequate regulation of insurers in order to protect citizens of this state; and that the department of insurance shall carry out and enforce such regulation. The courts of this state shall not enforce or give effect to any such covenant or agreement.
(L. 1991 H.B. 385, et al. § 109)
374.220. 1. The expenses of proceedings against insurance companies, and examinations of the assets or liabilities and valuations of policies of insurance companies doing business in this state, shall be assessed by the director upon the company proceeded against or examined, or whose policies have been valued.
2. If the company has been or shall be adjudged insolvent, or shall neglect, fail or refuse to pay the expenses, the director may approve the payment of the expenses, in whole or in part, which shall be paid in like manner as other expenses of the insurance department; and the amount so paid, together with cost, charges and fees for collecting the same, shall be a first lien upon all the assets and property of such company, and may be recovered by the director of revenue in any court of competent jurisdiction; or if said company be in liquidation, or process of being wound up, the cost and expenses of settling its affairs shall be allowed and taxed as cost against said company, and shall be a first lien upon and payable out of its assets. The director of revenue shall deposit such sums in the state treasury to reimburse the insurance fund.
3. Before any costs of any examination or valuation shall be paid, vouchers for the same shall be submitted to and approved by the commissioner of administration.
4. When any examination or valuation is made by the director in person or by any salaried employee of the department of insurance, the cost of making the same shall be certified to the director of revenue for collection.
(RSMo 1939 § 5795, A.L. 1945 p. 1018, A. 1949 H.B. 2115, A.L. 1967 p. 516, A.L. 1991 H.B. 385, et al.)Prior revisions: 1929 § 5685; 1919 § 6096; 1909 § 6890
Effective 7-1-92
(1956) Action for attorney fees against insurance director for services rendered state will not lie; only remedy provided is under § 374.220 and review of the director's decision under § 536.100. Barker v. Leggett (Mo.), 295 S.W.2d 836.
(1958) In prohibition proceeding against circuit judge where attorney had brought action against director of insurance in circuit court of county of attorney's residence for review of denial of attorney's claim for compensation, held judge lacked jurisdiction as director was not required by law to hold hearing on attorney's claim and, therefore, it was not a contested case within the meaning of § 536.100. State v. Jensen (Mo.), 318 S.W.2d 353.
(1960) Fees and expenses imposed under this section for examiners of insurance companies held not to be taxes. Leggett v. Missouri State Life Insurance Co. (Mo.), 342 S.W.2d 833.
(1962) Attorneys' fees, arising under 1930 agreement whereby director had agreed to pay attorneys out of unreturned excess premiums which attorneys might be successful in recovering from companies, could not be allowed as department expense payable out of current appropriations and state was not liable for fees by estoppel where method of payment provided in contract was invalid. State ex rel. Johnson v. Leggett (Mo.), 359 S.W.2d 790.
374.230. Every insurance company doing business in this state shall pay to the director of revenue the following fees:
(1) For filing the declaration required on organization of each domestic company, two hundred fifty dollars;
(2) For filing statement and certified copy of charter required of foreign companies, two hundred fifty dollars;
(3) For filing application to renew certificate of authority, along with all required annual reports, including the annual statement, actuarial statement, risk-based capital report, report of valuation of policies or other obligations of assurance, and audited financial report annual statement of any company doing business in this state, one thousand five hundred dollars;
(4) For filing supplementary annual statement of any company doing business in this state, fifty dollars;
(5) For filing any paper, document, or report not filed under subdivision (1), (2), or (3), but required to be filed in the office of the director, fifty dollars each;
(6) For a copy of a company's certificate of authority or producer or agent license, ten dollars;
(7) For affixing the seal of office of the director, ten dollars;
(8) For accepting each service of process upon the company, ten dollars.
(RSMo 1939 §§ 5795, 5796, A.L. 1945 p. 1018, A. 1949 H.B. 2115, A.L. 1967 p. 516, A.L. 1989 S.B. 250, A.L. 2007 S.B. 66)Prior revisions: 1929 §§ 5685, 5686; 1919 §§ 6096, 6097; 1909 §§ 6890, 6891
374.240. 1. The director may bring suit to recover any fees or other sums which he is authorized by law to demand or collect.
2. Any company or person liable for any fees or assessments who shall neglect or refuse to pay the same within ten days after written demand by the director, shall be liable to pay double the amount of such fees or assessments; and any judgment recovered in such case shall be for double such amount and costs.
(RSMo 1939 § 5797, A. 1949 H.B. 2115)Prior revisions: 1929 § 5687; 1919 § 6098; 1909 § 6892
374.245. The director of the department of insurance or the director of revenue may, within three years after a return is filed or at any time if no return is filed, make a supplemental assessment or certification whenever it is found that any assessment or certification of premium taxes covered by this section is imperfect or incomplete in any material aspect. The provisions of this section shall apply to taxes assessed under sections 148.310 to 148.461, RSMo, and sections 287.690, RSMo, and 375.916, RSMo.
(L. 1989 S.B. 260 § 1)
374.250. 1. The director shall take proper vouchers for all payments made by him and shall take receipts from the director of revenue for all moneys he pays to the director of revenue.
2. At the close of each state fiscal year, the state auditor shall audit, adjust and settle the accounts for all receipts and disbursements by the director.
(RSMo 1939 § 5797, A. 1949 H.B. 2115)Prior revisions: 1929 § 5687; 1919 § 6098; 1909 § 6892
374.270. 1. The department of insurance may elect, under the provisions of section 287.030, RSMo, to come under the provisions of chapter 287, governing workers' compensation, and that law is extended to include all employees of the department of insurance under any contract of hire, express or implied, oral or written, or under any appointment or election. The state of Missouri may be a self-insurer and assume all liability imposed by chapter 287, in respect to the department of insurance employees, without insurance. The attorney general shall appear on behalf of and defend the state in all actions, when the state is a self-insurer, brought by employees of the department of insurance referred to herein under the provisions of the workers' compensation law.
2. The workers' compensation coverage may be provided by the purchase of insurance or by the deposit in the commissioner of administration's office of a fund from which workers' compensation benefits to employees shall be paid. Purchase of the insurance or the deposit of a fund shall be made from general appropriations.
3. The department of insurance shall adopt rules classifying the employees mentioned herein who may be eligible for compensation under this section, and its classification shall be decisive as to whether or not an employee falls within the definition of an employee eligible for workers' compensation coverage under this section.
4. The director of the department of insurance is authorized to perform such duties as may be necessary to carry out effectively the purposes of this section.
(L. 1967 p. 516)
374.280. 1. The director may, after a hearing under section 374.046, order a civil penalty or forfeiture payable to the state of Missouri authorized by section 374.049, which penalty or forfeiture, if unpaid within ten days, may be recovered by a civil action brought by and in the name of the director under section 374.048. The civil action may be brought in the county which has venue of an action against the person, partnership or corporation under other provisions of law. The director may also suspend or revoke the license or certificate of authority of such person for any willful violation.
2. Nothing contained in this section shall be construed to prohibit the director and any person subject to an investigation, examination, or other proceeding from agreeing to a voluntary forfeiture of the sum mentioned herein without civil proceedings being instituted. Any sum so agreed upon shall be paid into the school fund as provided by law for other fines and penalties.
(L. 1967 p. 516, A.L. 1993 H.B. 709, A.L. 2007 S.B. 66)(1982) Legislature did not expressly provide private cause of actions for violation of section 379.118, although director of division of insurance may suspend or revoke license of an insurer for any willful violation of chapter 374. Shqeir v. Equifax, Inc. (Mo. banc) 636 S.W.2d 944.
374.284. The department of insurance shall create an advisory committee to be known as the "Health Insurance Advisory Committee". This committee shall be a voluntary committee comprised of representatives of the insurance industry, provider groups and the public. The committee shall consist of at least, but not limited to, one member representing each of the following areas: small group insurance, managed care, doctors of medicine, doctors of osteopathy, pharmacists, dentists and public members representing self-employed workers and the elderly. This committee shall meet to discuss and advise the department on issues relating to health care insurance.
(L. 1999 H.B. 191 § 2)
374.285. Except as provided in section 375.141, RSMo, all records of disciplinary actions against an insurance producer which resulted in a forfeiture or other monetary relief of two hundred dollars or less and places no other legal duty upon the producer shall be expunged after a period of five years from the date of the execution of the order or settlement agreement by the director.
(L. 2001 S.B. 193, A.L. 2007 S.B. 66)
374.300. As used in sections 374.300 to 374.310, "financial institution" means any bank, bank holding company, sales finance company, consumer finance company, credit union, insurance company, lender as that term is defined in subdivision (3) of section 367.100, RSMo, savings and loan association, savings and loan association holding company, savings and loan association service corporation, company operating under the mortgage brokerage laws of this state, or any subsidiary of any of the foregoing. This definition shall not, however, include any financial institution which has been granted an exemption by the Board of Governors of the Federal Reserve System pursuant to Section 4(d) of the Federal Bank Holding Company Act of 1956, as amended, or any financial institution which neither owns more than ten percent of the capital stock nor exercises effective control of a bank, savings and loan association or entity licensed under the mortgage brokerage laws of this state, which is licensed or authorized to transact business in this state.
(L. 1977 H.B. 40 § 1)
374.305. No financial institution, as defined in section 374.300, shall, as a condition of a loan, require any debtor to purchase life or health insurance from an agent who is employed or retained by, or is a director or officer of the financial institution making the loan. When life or accident and sickness insurance is required or requested as additional security for indebtedness, the debtor shall be informed of the option of furnishing the insurance, or any portion thereof, through existing policies owned or controlled by the debtor, or of procuring and furnishing the required coverage through any agent or insurer authorized to transact such insurance business within this state.
(L. 1977 H.B. 40 § 2)
374.310. The director of insurance shall not grant or renew any life or health insurance license if the license has been or is being used by the applicant or licensee for any purpose prohibited by sections 374.300 to 374.310. Before the director can deny renewal he shall be required to hold a public hearing, with ten days' notice to the applicant, to determine whether the license has been or is being used contrary to the mandates of sections 374.300 to 374.310. Appeal from the decision of the director shall be to the administrative hearing commission which shall conduct a hearing de novo.
(L. 1977 H.B. 40 § 3)
374.400. Unless otherwise clearly indicated by the context, the following words and terms as used in sections 374.400 to 374.410 shall mean:
(1) "Director", the director of the department of insurance;
(2) "Dwelling-owners' insurance", a policy of insurance on a one- or two-family owner-occupied premises* which combines fire and allied lines with any one or more perils of casualty, liability, or other types of insurance within one policy form at a single premium, where the insurer's liability for damage to the premises* under said policy is determined with reference to the premises' actual cash value;
(3) "Homeowners' insurance", a policy of insurance on a one- or two-family owner-occupied premises* which combines fire and allied lines with any one or more perils of casualty, liability, or other types of insurance within one policy form at a single premium, where the insurer's liability for damage to the premises* under said policy is determined with reference to the premises' replacement value;
(4) "Insurer", any insurance company, reciprocal or inter-insurance exchange, licensed and authorized by the director to write homeowners' insurance, dwelling-owners' insurance, renters' or tenants' insurance, or residential fire insurance upon property located within this state;
(5) "Renters' or tenants' insurance", a policy of insurance on a single- or multiple-family premises* which combines fire and allied lines with any one or more perils of casualty, liability, or other types of insurance within one policy form at a single premium, where the insurer's liability for damage to the contents of the premises* under said policy is determined with reference to the contents' actual cash value;
(6) "Residential fire insurance", a policy of insurance which provides fire coverage or fire and allied lines coverage on a residential premises* within one policy form, where the insurer's liability for damage to the premises* under said policy is determined with reference to the premises' actual cash value.
(L. 1978 H.B. 1302 § 1)*Word "premise" appears in original rolls.
374.405. 1. The director shall establish statistical bases for the reporting of premium and loss data under policies of homeowners' insurance, dwelling-owners' insurance, renters' or tenants' insurance, or residential fire insurance.
2. Each insurer shall annually report to the director all premium and loss data under policies of homeowners' insurance, dwelling-owners' insurance, renters' or tenants' insurance, or residential fire insurance as the director may require.
3. The director shall have the authority to review and verify the accuracy of the data reported.
(L. 1978 H.B. 1302 § 2)
374.410. Whenever any insurer, group, association or other organization of insurers, or rating organization shall change any town grading schedule used in connection with the development of rates under policies of homeowners' insurance, dwelling-owners' insurance, renters' or tenants' insurance, or residential fire insurance written upon property located within this state, such change shall be filed with the director of the department of insurance. The director of the department of insurance may set aside any change in town grading schedules that he finds is not supported by substantial evidence and credible data acquired under sections 374.400 to 374.410.
(L. 1978 H.B. 1302 § 3)
374.415. 1. As used in sections 374.400 to 374.425, "product liability insurance" or "product liability policy" means:
(1) Any policy of insurance insuring only the insured's legal obligation arising from the product liability exposure of the insured;
(2) Any other policy of liability insurance in which the premium computation includes a specific premium charge for product liability exposures of the insured; and
(3) Any other insurance policy designated by the commissioner of insurance as providing product liability insurance.
2. Every insurer authorized to transact business in this state and providing product liability insurance shall, if asked by the department of insurance, on the first day of January of each year in which said insurer actually provides product liability insurance in Missouri or within sixty days thereafter, file with the director of insurance a report containing the information hereinafter specified; provided, however, insurers are not required to report product liability information pursuant to sections 374.400 to 374.425 for business incidental to the operation of affiliated companies or organizations. Such report may be made upon forms provided by the director of insurance and shall request the following information:
(1) The name of the insurance company;
(2) The name of all other companies associated with the company submitting the report, as either a holding company, parent, wholly owned subsidiary, division, or through interlocking directorates;
(3) All the lines of insurance a company offers in all states;
(4) The states in which the company has been admitted for product liability insurance;
(5) The total premium dollar amount collected for all lines of insurance in Missouri and in all states in each of the five calendar years next preceding the initial report or in the year next preceding the filing of each annual report thereafter;
(6) The dollar amount collected each year in product liability premiums in Missouri and in all states beginning with calendar year 1978;
(7) The amount in dollars of product liability premiums for primary coverage and for excess coverage in Missouri and i