375.772. 1. There is created a nonprofit unincorporated legal entity tobe known as the "Missouri Property and Casualty Insurance GuarantyAssociation", hereinafter referred to as "association". All member insurersshall be and remain members of the association as a condition of theirauthority to transact insurance in this state. The association shall performits functions under a plan of operation and through a board of directorsestablished by section 375.776.
2. As used in sections 375.771 to 375.779, the following terms mean:
(1) "Account", any one of the four accounts established by section375.773;
(2) "Affiliate", a person who directly or indirectly through one or moreintermediaries controls, is controlled by, or is under common control withanother person;
(3) "Affiliate of an insolvent insurer", a person who directly orindirectly through one or more intermediaries controls, is controlled by, oris under common control with an insolvent insurer on December thirty-first ofthe year immediately preceding the date the insurer becomes an insolventinsurer;
(4) "Association", the Missouri property and casualty insurance guarantyassociation;
(5) "Claimant", any insured making a first-party claim or any personinstituting a liability claim, provided that no person who is an affiliate ofthe insolvent insurer may be a claimant;
(6) "Control", the possession, direct or indirect, of the power todirect or cause the direction of the management and policies of a person,whether through the ownership of voting securities, by contract other than acommercial contract for goods or nonmanagement services, or otherwise, unlessthe power is the result of an official position with the corporate office heldby the person. Control shall be presumed to exist if any person, directly orindirectly, owns, controls, holds the power to vote, or holds proxiesrepresenting ten percent or more of the voting securities of any other person. Such presumption may be rebutted by a showing that control does not exist infact;
(7) "Covered claim", an unpaid claim including those for unearnedpremiums, presented by a claimant within the time specified in accordance withsubsection 1 and subdivision (2) of subsection 2 of section 375.775, and isfor a loss arising out of and is within the coverage of an insurance policy towhich sections 375.771 to 375.779 apply made by a person insured under suchpolicy or by a person suffering injury or for which a person insured undersuch policy is legally liable, if:
(a) The policy is issued by a member insurer and such member insurerbecomes an insolvent insurer after August 28, 2004; and
(b) The claimant or insured is a resident of this state at the time ofthe insured event, or the claim is a first-party claim by an insured fordamage to property and the property from which the claim arises is permanentlylocated in this state or in the case of an unearned premium, the policyholderis a resident of this state at the time the policy is issued. The residencyof the claimant, insured, or policyholder, other than an individual, is thestate in which its principal place of business is located at the time of theinsured event;
(c) "Covered claim" shall not include:
a. Any amount awarded as punitive or exemplary damages, or which is afine or penalty;
b. Any amount sought as a return of premium under any retrospectiverating plan; or
c. Any amount due any reinsurer, insurer, insurance pool, orunderwriting association, health maintenance organization, hospital plancorporation, health services corporation, or self-insurer as subrogationrecoveries, reinsurance recoveries, contribution, indemnity, or otherwise. Tothe extent of any amount due any reinsurer, insurer, insurance pool, orunderwriting association, health maintenance organization, hospital plancorporation, health services corporation, or self-insurer as subrogationrecoveries or otherwise there shall be no right of recovery by any personagainst a tortfeasor insured of an insolvent insurer, except that suchlimitation shall not apply with respect to those amounts that exceed thelimits of the policy issued such tortfeasor by the insolvent insurer;
d. A claim by or against an insured of an insolvent insurer, if suchinsured has a net worth of more than twenty-five million dollars on the laterof the end of the insured's most recent fiscal year or the Decemberthirty-first of the year next preceding the date the insurer becomes aninsolvent insurer; provided that an insured's net worth on such date shall bedeemed to include the aggregate net worth of the insured and all of itsaffiliates as calculated on a consolidated basis;
e. Any first-party claim by an insured which is an affiliate of theinsolvent insurer;
f. Supplementary payment obligations incurred prior to the final orderof liquidation, including but not limited to adjustment fees and expenses,fees for medical cost containment services, including but not limited tomedical case management fees, attorney's fees and expenses, court costs,penalties, and bond premiums;
g. Any claims for interest;
h. Any amount that constitutes a portion of a covered claim that iswithin an insured's deductible or self-insured retention;
i. Any fee or other amount sought by or on behalf of an attorney orother provider of goods or services retained by an insured or claimant inconnection with the assertion or prosecuting of any claim, covered orotherwise, against the association;
j. Any amount that constitutes a claim under a policy issued by aninsolvent insurer with a deductible or self-insured retention of three hundredthousand dollars or more. However, such a claim shall be considered a coveredclaim, if, as of the deadline set forth for the filing of claims against theinsolvent insurer or its liquidator, the insured is a debtor under 11 U.S.C.Section 701, et seq.;
k. Any amount to the extent that it is covered by any insurance that isavailable to the claimant or the insured, whether such other insurance isprimary, pro rata, or excess. In all such instances, the association'sobligations to the insured or claimant shall not be deemed to be otherinsurance;
(8) "Insolvent insurer", an insurer licensed to transact insurance inthis state, either at the time the policy was issued or when the insured eventoccurred, and against whom a final order of liquidation with a finding ofinsolvency has been entered by a court of competent jurisdiction in theinsurer's state of domicile or of this state under the provisions of sections375.950 to 375.990 or sections 375.1150 to 375.1246, and which such order ofliquidation has not been stayed or been the subject of a writ of supersedeasor other comparable order;
(9) "Insured", any named insured, additional insured, vendor, lessor, orany other party identified as an insured under the policy;
(10) "Member insurer", any person who writes any kind of insurance towhich sections 375.771 to 375.779 apply, including the exchange of reciprocalor interinsurance contracts, and possesses a certificate of authority totransact the business of insurance in this state issued by the director of thedepartment of insurance, financial institutions and professional registration. Whether or not approved by the director of the department of insurance,financial institutions and professional registration for the placing of linesof insurance by producers so authorized under the provisions of chapter 384,RSMo, an insurance company not licensed to do business in this state shall notbe a member insurer. Missouri mutual and extended Missouri mutual insurancecompanies doing business under chapter 380, RSMo, shall be considered memberinsurers for the purposes of sections 375.771 to 375.779, and a specialaccount shall be established applicable only to such companies;
(11) "Net direct written premiums", direct gross premiums written inthis state on insurance policies to which sections 375.771 to 375.779 apply,less return premiums thereon and dividends paid or credited to policyholderson such direct business. "Net direct written premiums" does not includepremiums on contracts between insurers or reinsurers;
(12) "Net worth", the total assets of a person less the totalliabilities against those assets. Where the person is one who prepares anannual report to shareholders such report for the fiscal year immediatelypreceding the date of insolvency of the insurance carrier shall be used todetermine net worth. If the person is one who does not prepare such an annualreport, but does prepare an annual financial report for management whichreflects net worth, then such report for the fiscal year immediately precedingthe date of insolvency of the insurance carrier shall be used to determine networth;
(13) "Ocean marine insurance" includes marine insurance that insuresagainst maritime perils or risks and other related perils or risks which areusually insured against by traditional marine insurance, such as hull andmachinery, marine builders' risks, and marine protection and indemnity. Suchperils and risks insured against include, without limitation, loss, damage, orexpense or legal liability of the insured arising out of an incident relatedto ownership, operation, chartering, maintenance, use, repair, or constructionof any vessel, craft, or instrumentality in use in ocean or inland waters forcommercial purposes, including liability of the insured for personal injury,illness, or death for loss or damage to the property of the insured or anotherperson;
(14) "Person", any individual, corporation, partnership, association orvoluntary organization, municipality, or political subdivision;
(15) "Political subdivision", the same meaning as such term is definedin section 70.210, RSMo;
(16) "Self-insurer", a person that covers its liability through aqualified individual or group self-insurance program or any other formalprogram created for the specific purpose of covering liabilities typicallycovered by insurance. Self-insurer does not include the Missouri privatesector individual self-insurers guaranty corporation created pursuant tosection 287.860, RSMo, et seq.
375.772. 1. There is created a nonprofit unincorporated legal entity tobe known as the "Missouri Property and Casualty Insurance GuarantyAssociation", hereinafter referred to as "association". All member insurersshall be and remain members of the association as a condition of theirauthority to transact insurance in this state. The association shall performits functions under a plan of operation and through a board of directorsestablished by section 375.776.
2. As used in sections 375.771 to 375.779, the following terms mean:
(1) "Account", any one of the four accounts established by section375.773;
(2) "Affiliate", a person who directly or indirectly through one or moreintermediaries controls, is controlled by, or is under common control withanother person;
(3) "Affiliate of an insolvent insurer", a person who directly orindirectly through one or more intermediaries controls, is controlled by, oris under common control with an insolvent insurer on December thirty-first ofthe year immediately preceding the date the insurer becomes an insolventinsurer;
(4) "Association", the Missouri property and casualty insurance guarantyassociation;
(5) "Claimant", any insured making a first-party claim or any personinstituting a liability claim, provided that no person who is an affiliate ofthe insolvent insurer may be a claimant;
(6) "Control", the possession, direct or indirect, of the power todirect or cause the direction of the management and policies of a person,whether through the ownership of voting securities, by contract other than acommercial contract for goods or nonmanagement services, or otherwise, unlessthe power is the result of an official position with the corporate office heldby the person. Control shall be presumed to exist if any person, directly orindirectly, owns, controls, holds the power to vote, or holds proxiesrepresenting ten percent or more of the voting securities of any other person. Such presumption may be rebutted by a showing that control does not exist infact;
(7) "Covered claim", an unpaid claim including those for unearnedpremiums, presented by a claimant within the time specified in accordance withsubsection 1 and subdivision (2) of subsection 2 of section 375.775, and isfor a loss arising out of and is within the coverage of an insurance policy towhich sections 375.771 to 375.779 apply made by a person insured under suchpolicy or by a person suffering injury or for which a person insured undersuch policy is legally liable, if:
(a) The policy is issued by a member insurer and such member insurerbecomes an insolvent insurer after August 28, 2004; and
(b) The claimant or insured is a resident of this state at the time ofthe insured event, or the claim is a first-party claim by an insured fordamage to property and the property from which the claim arises is permanentlylocated in this state or in the case of an unearned premium, the policyholderis a resident of this state at the time the policy is issued. The residencyof the claimant, insured, or policyholder, other than an individual, is thestate in which its principal place of business is located at the time of theinsured event;
(c) "Covered claim" shall not include:
a. Any amount awarded as punitive or exemplary damages, or which is afine or penalty;
b. Any amount sought as a return of premium under any retrospectiverating plan; or
c. Any amount due any reinsurer, insurer, insurance pool, orunderwriting association, health maintenance organization, hospital plancorporation, health services corporation, or self-insurer as subrogationrecoveries, reinsurance recoveries, contribution, indemnity, or otherwise. Tothe extent of any amount due any reinsurer, insurer, insurance pool, orunderwriting association, health maintenance organization, hospital plancorporation, health services corporation, or self-insurer as subrogationrecoveries or otherwise there shall be no right of recovery by any personagainst a tortfeasor insured of an insolvent insurer, except that suchlimitation shall not apply with respect to those amounts that exceed thelimits of the policy issued such tortfeasor by the insolvent insurer;
d. A claim by or against an insured of an insolvent insurer, if suchinsured has a net worth of more than twenty-five million dollars on the laterof the end of the insured's most recent fiscal year or the Decemberthirty-first of the year next preceding the date the insurer becomes aninsolvent insurer; provided that an insured's net worth on such date shall bedeemed to include the aggregate net worth of the insured and all of itsaffiliates as calculated on a consolidated basis;
e. Any first-party claim by an insured which is an affiliate of theinsolvent insurer;
f. Supplementary payment obligations incurred prior to the final orderof liquidation, including but not limited to adjustment fees and expenses,fees for medical cost containment services, including but not limited tomedical case management fees, attorney's fees and expenses, court costs,penalties, and bond premiums;
g. Any claims for interest;
h. Any amount that constitutes a portion of a covered claim that iswithin an insured's deductible or self-insured retention;
i. Any fee or other amount sought by or on behalf of an attorney orother provider of goods or services retained by an insured or claimant inconnection with the assertion or prosecuting of any claim, covered orotherwise, against the association;
j. Any amount that constitutes a claim under a policy issued by aninsolvent insurer with a deductible or self-insured retention of three hundredthousand dollars or more. However, such a claim shall be considered a coveredclaim, if, as of the deadline set forth for the filing of claims against theinsolvent insurer or its liquidator, the insured is a debtor under 11 U.S.C.Section 701, et seq.;
k. Any amount to the extent that it is covered by any insurance that isavailable to the claimant or the insured, whether such other insurance isprimary, pro rata, or excess. In all such instances, the association'sobligations to the insured or claimant shall not be deemed to be otherinsurance;
(8) "Insolvent insurer", an insurer licensed to transact insurance inthis state, either at the time the policy was issued or when the insured eventoccurred, and against whom a final order of liquidation with a finding ofinsolvency has been entered by a court of competent jurisdiction in theinsurer's state of domicile or of this state under the provisions of sections375.950 to 375.990 or sections 375.1150 to 375.1246, and which such order ofliquidation has not been stayed or been the subject of a writ of supersedeasor other comparable order;
(9) "Insured", any named insured, additional insured, vendor, lessor, orany other party identified as an insured under the policy;
(10) "Member insurer", any person who writes any kind of insurance towhich sections 375.771 to 375.779 apply, including the exchange of reciprocalor interinsurance contracts, and possesses a certificate of authority totransact the business of insurance in this state issued by the director of thedepartment of insurance, financial institutions and professional registration. Whether or not approved by the director of the department of insurance,financial institutions and professional registration for the placing of linesof insurance by producers so authorized under the provisions of chapter 384,RSMo, an insurance company not licensed to do business in this state shall notbe a member insurer. Missouri mutual and extended Missouri mutual insurancecompanies doing business under chapter 380, RSMo, shall be considered memberinsurers for the purposes of sections 375.771 to 375.779, and a specialaccount shall be established applicable only to such companies;
(11) "Net direct written premiums", direct gross premiums written inthis state on insurance policies to which sections 375.771 to 375.779 apply,less return premiums thereon and dividends paid or credited to policyholderson such direct business. "Net direct written premiums" does not includepremiums on contracts between insurers or reinsurers;
(12) "Net worth", the total assets of a person less the totalliabilities against those assets. Where the person is one who prepares anannual report to shareholders such report for the fiscal year immediatelypreceding the date of insolvency of the insurance carrier shall be used todetermine net worth. If the person is one who does not prepare such an annualreport, but does prepare an annual financial report for management whichreflects net worth, then such report for the fiscal year immediately precedingthe date of insolvency of the insurance carrier shall be used to determine networth;
(13) "Ocean marine insurance" includes marine insurance that insuresagainst maritime perils or risks and other related perils or risks which areusually insured against by traditional marine insurance, such as hull andmachinery, marine builders' risks, and marine protection and indemnity. Suchperils and risks insured against include, without limitation, loss, damage, orexpense or legal liability of the insured arising out of an incident relatedto ownership, operation, chartering, maintenance, use, repair, or constructionof any vessel, craft, or instrumentality in use in ocean or inland waters forcommercial purposes, including liability of the insured for personal injury,illness, or death for loss or damage to the property of the insured or anotherperson;
(14) "Person", any individual, corporation, partnership, association orvoluntary organization, municipality, or political subdivision;
(15) "Political subdivision", the same meaning as such term is definedin section 70.210, RSMo;
(16) "Self-insurer", a person that covers its liability through aqualified individual or group self-insurance program or any other formalprogram created for the specific purpose of covering liabilities typicallycovered by insurance. Self-insurer does not include the Missouri privatesector individual self-insurers guaranty corporation created pursuant tosection 287.860, RSMo, et seq.
375.772. 1. There is created a nonprofit unincorporated legal entity tobe known as the "Missouri Property and Casualty Insurance GuarantyAssociation", hereinafter referred to as "association". All member insurersshall be and remain members of the association as a condition of theirauthority to transact insurance in this state. The association shall performits functions under a plan of operation and through a board of directorsestablished by section 375.776.
2. As used in sections 375.771 to 375.779, the following terms mean:
(1) "Account", any one of the four accounts established by section375.773;
(2) "Affiliate", a person who directly or indirectly through one or moreintermediaries controls, is controlled by, or is under common control withanother person;
(3) "Affiliate of an insolvent insurer", a person who directly orindirectly through one or more intermediaries controls, is controlled by, oris under common control with an insolvent insurer on December thirty-first ofthe year immediately preceding the date the insurer becomes an insolventinsurer;
(4) "Association", the Missouri property and casualty insurance guarantyassociation;
(5) "Claimant", any insured making a first-party claim or any personinstituting a liability claim, provided that no person who is an affiliate ofthe insolvent insurer may be a claimant;
(6) "Control", the possession, direct or indirect, of the power todirect or cause the direction of the management and policies of a person,whether through the ownership of voting securities, by contract other than acommercial contract for goods or nonmanagement services, or otherwise, unlessthe power is the result of an official position with the corporate office heldby the person. Control shall be presumed to exist if any person, directly orindirectly, owns, controls, holds the power to vote, or holds proxiesrepresenting ten percent or more of the voting securities of any other person. Such presumption may be rebutted by a showing that control does not exist infact;
(7) "Covered claim", an unpaid claim including those for unearnedpremiums, presented by a claimant within the time specified in accordance withsubsection 1 and subdivision (2) of subsection 2 of section 375.775, and isfor a loss arising out of and is within the coverage of an insurance policy towhich sections 375.771 to 375.779 apply made by a person insured under suchpolicy or by a person suffering injury or for which a person insured undersuch policy is legally liable, if:
(a) The policy is issued by a member insurer and such member insurerbecomes an insolvent insurer after August 28, 2004; and
(b) The claimant or insured is a resident of this state at the time ofthe insured event, or the claim is a first-party claim by an insured fordamage to property and the property from which the claim arises is permanentlylocated in this state or in the case of an unearned premium, the policyholderis a resident of this state at the time the policy is issued. The residencyof the claimant, insured, or policyholder, other than an individual, is thestate in which its principal place of business is located at the time of theinsured event;
(c) "Covered claim" shall not include:
a. Any amount awarded as punitive or exemplary damages, or which is afine or penalty;
b. Any amount sought as a return of premium under any retrospectiverating plan; or
c. Any amount due any reinsurer, insurer, insurance pool, orunderwriting association, health maintenance organization, hospital plancorporation, health services corporation, or self-insurer as subrogationrecoveries, reinsurance recoveries, contribution, indemnity, or otherwise. Tothe extent of any amount due any reinsurer, insurer, insurance pool, orunderwriting association, health maintenance organization, hospital plancorporation, health services corporation, or self-insurer as subrogationrecoveries or otherwise there shall be no right of recovery by any personagainst a tortfeasor insured of an insolvent insurer, except that suchlimitation shall not apply with respect to those amounts that exceed thelimits of the policy issued such tortfeasor by the insolvent insurer;
d. A claim by or against an insured of an insolvent insurer, if suchinsured has a net worth of more than twenty-five million dollars on the laterof the end of the insured's most recent fiscal year or the Decemberthirty-first of the year next preceding the date the insurer becomes aninsolvent insurer; provided that an insured's net worth on such date shall bedeemed to include the aggregate net worth of the insured and all of itsaffiliates as calculated on a consolidated basis;
e. Any first-party claim by an insured which is an affiliate of theinsolvent insurer;
f. Supplementary payment obligations incurred prior to the final orderof liquidation, including but not limited to adjustment fees and expenses,fees for medical cost containment services, including but not limited tomedical case management fees, attorney's fees and expenses, court costs,penalties, and bond premiums;
g. Any claims for interest;
h. Any amount that constitutes a portion of a covered claim that iswithin an insured's deductible or self-insured retention;
i. Any fee or other amount sought by or on behalf of an attorney orother provider of goods or services retained by an insured or claimant inconnection with the assertion or prosecuting of any claim, covered orotherwise, against the association;
j. Any amount that constitutes a claim under a policy issued by aninsolvent insurer with a deductible or self-insured retention of three hundredthousand dollars or more. However, such a claim shall be considered a coveredclaim, if, as of the deadline set forth for the filing of claims against theinsolvent insurer or its liquidator, the insured is a debtor under 11 U.S.C.Section 701, et seq.;
k. Any amount to the extent that it is covered by any insurance that isavailable to the claimant or the insured, whether such other insurance isprimary, pro rata, or excess. In all such instances, the association'sobligations to the insured or claimant shall not be deemed to be otherinsurance;
(8) "Insolvent insurer", an insurer licensed to transact insurance inthis state, either at the time the policy was issued or when the insured eventoccurred, and against whom a final order of liquidation with a finding ofinsolvency has been entered by a court of competent jurisdiction in theinsurer's state of domicile or of this state under the provisions of sections375.950 to 375.990 or sections 375.1150 to 375.1246, and which such order ofliquidation has not been stayed or been the subject of a writ of supersedeasor other comparable order;
(9) "Insured", any named insured, additional insured, vendor, lessor, orany other party identified as an insured under the policy;
(10) "Member insurer", any person who writes any kind of insurance towhich sections 375.771 to 375.779 apply, including the exchange of reciprocalor interinsurance contracts, and possesses a certificate of authority totransact the business of insurance in this state issued by the director of thedepartment of insurance, financial institutions and professional registration. Whether or not approved by the director of the department of insurance,financial institutions and professional registration for the placing of linesof insurance by producers so authorized under the provisions of chapter 384,RSMo, an insurance company not licensed to do business in this state shall notbe a member insurer. Missouri mutual and extended Missouri mutual insurancecompanies doing business under chapter 380, RSMo, shall be considered memberinsurers for the purposes of sections 375.771 to 375.779, and a specialaccount shall be established applicable only to such companies;
(11) "Net direct written premiums", direct gross premiums written inthis state on insurance policies to which sections 375.771 to 375.779 apply,less return premiums thereon and dividends paid or credited to policyholderson such direct business. "Net direct written premiums" does not includepremiums on contracts between insurers or reinsurers;
(12) "Net worth", the total assets of a person less the totalliabilities against those assets. Where the person is one who prepares anannual report to shareholders such report for the fiscal year immediatelypreceding the date of insolvency of the insurance carrier shall be used todetermine net worth. If the person is one who does not prepare such an annualreport, but does prepare an annual financial report for management whichreflects net worth, then such report for the fiscal year immediately precedingthe date of insolvency of the insurance carrier shall be used to determine networth;
(13) "Ocean marine insurance" includes marine insurance that insuresagainst maritime perils or risks and other related perils or risks which areusually insured against by traditional marine insurance, such as hull andmachinery, marine builders' risks, and marine protection and indemnity. Suchperils and risks insured against include, without limitation, loss, damage, orexpense or legal liability of the insured arising out of an incident relatedto ownership, operation, chartering, maintenance, use, repair, or constructionof any vessel, craft, or instrumentality in use in ocean or inland waters forcommercial purposes, including liability of the insured for personal injury,illness, or death for loss or damage to the property of the insured or anotherperson;
(14) "Person", any individual, corporation, partnership, association orvoluntary organization, municipality, or political subdivision;
(15) "Political subdivision", the same meaning as such term is definedin section 70.210, RSMo;
(16) "Self-insurer", a person that covers its liability through aqualified individual or group self-insurance program or any other formalprogram created for the specific purpose of covering liabilities typicallycovered by insurance. Self-insurer does not include the Missouri privatesector individual self-insurers guaranty corporation created pursuant tosection 287.860, RSMo, et seq.
