State Codes and Statutes

Statutes > Wyoming > Title26 > Chapter15

CHAPTER 15 - THE INSURANCE CONTRACT

 

ARTICLE 1 - IN GENERAL

 

26-15-101. Scope of chapter.

 

 

(a) This chapter applies to all insurance contracts and annuitycontracts except:

 

(i) Reinsurance;

 

(ii) Policies or contracts not issued for delivery in this statenor delivered in this state;

 

(iii) Wet marine and transportation insurance.

 

26-15-102. Life insurance upon individual or person in whom he hasinsurable interest; "insurable interest" defined.

 

 

(a) Any individual of competent legal capacity may procure oreffect an insurance contract upon his own life or body for the benefit of anyperson. Except as provided in W.S. 26-15-103, no person shall procure or causeto be procured any insurance contract upon the life or body of anotherindividual unless the benefits under the contract are payable to the individualinsured or his personal representatives, or to a person having, at the timewhen the contract is made, an insurable interest in the individual insured.

 

(b) If the beneficiary, assignee or other payee under anycontract made in violation of this section receives from the insurer anybenefits thereunder accruing upon the death, disablement or injury of theindividual insured, the individual insured or his executor or administrator, asthe case may be, may maintain an action to recover the benefits from the personreceiving them.

 

(c) "Insurable interest" as to personal insurancemeans that any individual has an insurable interest in the life, body andhealth of himself, and of other persons as follows:

 

(i) In the case of individuals related closely by blood or bylaw, a substantial interest engendered by love and affection;

 

(ii) In the case of other persons, a lawful and substantialeconomic interest in having the life, health or bodily safety of the individualinsured continue, as distinguished from an interest arising only by, orenhanced in value by, the death, disablement or injury of the individualinsured; and

 

(iii) An individual party to a contract or option for thepurchase or sale of an interest in a business partnership or firm, or of sharesof stock of a closed corporation or of an interest in those shares, has aninsurable interest in the life of each individual party to the contract and forthe purposes of the contract only, in addition to any insurable interest whichotherwise exists as to that individual's life.

 

(d) An insurer may rely upon all statements, declarations andrepresentations made by an applicant for insurance relative to the applicant'sinsurable interest in the insured. No insurer incurs legal liability, except asset forth in the policy, by virtue of any untrue statements, declarations orrepresentations relied upon in good faith.

 

26-15-103. Life insurance for benefit of charitable institutions.

 

 

(a) Contracts of life insurance may be made and entered into inwhich the person paying the consideration for the insurance has no insurableinterest in the life of the person insured, if charitable, benevolent,educational or religious institutions are designated irrevocably as abeneficiary but not necessarily the primary beneficiary thereof.

 

(b) In making a contract as specified in subsection (a) of thissection, the person paying the premium shall make and sign the applicationtherefor as owner and shall designate a charitable, benevolent, educational orreligious institution irrevocably as the beneficiary or one (1) of thebeneficiaries of the policy. The application also shall be signed by the personwhose life is to be insured.

 

(c) The contract is valid and binding among all of the partiesthereto, notwithstanding that the owner has no insurable interest in the lifeof the person insured.

 

26-15-104. Insurable interest in property; "insurableinterest" defined.

 

 

(a) No contract of insurance of property or of any interest inproperty or arising from property is enforceable as to the insurance except forthe benefit of persons having an insurable interest in the things insured atthe time of the loss.

 

(b) The measure of an insurable interest in property is theextent to which the insured might be directly or indirectly damnified by lossor impairment thereof.

 

(c) "Insurable interest" as used in this sectionmeans any actual, lawful and substantial economic interest in the safety orpreservation of the subject of the insurance free from loss, destruction orpecuniary damage or impairment.

 

26-15-105. Purchase of life insurance by or for minors or any person ofcompetent legal capacity.

 

 

(a) Any person of competent legal capacity may contract forinsurance.

 

(b) Any minor not less than fifteen (15) years of age,notwithstanding his minority, may contract for or own annuities, or insurance,or affirm by novation or otherwise preexisting contracts for annuities orinsurance upon his own life, body, health, property, liabilities or otherinterests, or on the person of another in whom the minor has an insurableinterest. The minor, notwithstanding his minority, may exercise all rights andpowers with respect to or under any contract for annuity or for insurance uponhis own life, body or health, or any contract the minor effects upon his ownproperty, liabilities or other interests, or any contract the minor owns oreffects on the person of another, as might be exercised by a person of fulllegal age, and may at any time surrender his interest in any such contracts andgive valid discharge for any benefit accruing or money payable thereunder. Theminor, by reason of his minority, is not entitled to rescind, avoid orrepudiate the contract, nor to rescind, avoid or repudiate any exercise of aright or privilege thereunder, except that such a minor not otherwiseemancipated is not bound by any unperformed agreement to pay, by promissorynote or otherwise, any premium on any such annuity or insurance contract.

 

(c) Any annuity contract or policy of life disability insuranceprocured by or for a minor under subsection (b) of this section, shall be madepayable either to the minor or his estate or to a person having an insurableinterest in the minor's life.

 

26-15-106. Application to be made by individual insured; exceptions.

 

 

(a) No life or disability insurance contract upon anindividual, except a contract of group life insurance or of group or blanketdisability insurance, shall be made or carried out unless at the time of themaking of the contract the individual insured, being of competent legalcapacity to contract, applies therefor or has consented thereto in writing,except:

 

(i) A spouse may carry out the insurance upon the other spouse;

 

(ii) Any person having an insurable interest in the life of aminor, or any person upon whom a minor is dependent for support andmaintenance, may carry out insurance upon the life of or pertaining to theminor;

 

(iii) Family policies may be issued insuring any two (2) or moremembers of a family on an application signed by either parent, a stepparent orby a husband or wife.

 

26-15-107. Alteration of application prohibited; exceptions.

 

Noalteration of any written application for any life or disability insurancepolicy shall be made by any person other than the applicant without his writtenconsent, except that the insurer may make insertions for administrativepurposes only in a manner as to indicate clearly that the insertions are not tobe ascribed to the applicant.

 

26-15-108. Application as evidence.

 

 

(a) No application for the issuance of any life or disabilityinsurance policy or annuity contract is admissible in evidence in any actionrelative to the policy or contract, unless a true copy of the application isattached to or otherwise made a part of the policy or contract when issued.This provision does not apply to industrial life insurance policies.

 

(b) If any life or disability insurance policy delivered inthis state is reinstated or renewed, and the insured or the policy beneficiaryor assignee makes written request to the insurer for a copy of thereinstatement or renewal application, if any, the insurer, within thirty (30)days after receipt of the request at its home office, shall deliver or mail tothe person making the request a copy of the application reproduced by anylegible means. If the copy is not delivered or mailed after having beenrequested, the insurer is precluded from introducing the application in evidencein any action or proceeding based upon or involving the policy or itsreinstatement or renewal. In the case of a request from a beneficiary, the timewithin which the insurer is required to furnish a copy of the application doesnot begin to run until after receipt of evidence satisfactory to the insurer ofthe beneficiary's vested interest in the policy or contract.

 

(c) As to insurance other than life or disability insurance, noapplication for insurance signed by or on behalf of the insured is admissiblein evidence in any action between the insured and the insurer arising out ofthe policy so applied for, if the insurer fails, at expiration of thirty (30)days after receipt of written demand therefor by or on behalf of the insured,to furnish to the insured a copy of the application reproduced by any legiblemeans.

 

26-15-109. Statements in applications as representations and not aswarranties; misrepresentations.

 

 

(a) Any statements and descriptions in any application for aninsurance policy or annuity contract, by or in behalf of the insured orannuitant, are representations and not warranties. Misrepresentations,omissions, concealment of facts and incorrect statements do not prevent arecovery under the policy or contract unless either:

 

(i) Fraudulent; or

 

(ii) Material either to the acceptance of the risk, or to thehazard the insurer assumes; or

 

(iii) The insurer in good faith, if it knew the true facts asrequired by the application for the policy or contract or otherwise, would nothave:

 

(A) Issued the policy or contract;

 

(B) Issued it at the same premium rate;

 

(C) Issued a policy or contract in as large an amount; or

 

(D) Provided coverage with respect to the hazard resulting inthe loss.

 

26-15-110. Filing and approval of application forms.

 

(a) No basic insurance policy or annuity contract form, orapplication form if written application is required and is to be made a part ofthe policy or contract, or printed rider or endorsement form or form of renewalcertificate, shall be delivered or issued for delivery in this state unless theform is filed with and approved by the commissioner or is approved as providedin W.S. 26-15-201. This provision does not apply to surety bonds, or tospecially rated inland marine risks, nor to policies, riders, endorsements orforms of unique character designed for and used with relation to insurance upona particular subject, or which relate to the manner of distribution of benefitsor to the reservation of rights and benefits under life or disability insurancepolicies and are used at the request of the individual policyholder, contractholder or certificate holder. As to forms for use in property, marine, otherthan wet marine and transportation insurance, casualty and surety insurance coverages,the filing required by this subsection may be made by advisory and ratingorganizations on behalf of their members and subscribers. This provision doesnot prohibit any member or subscriber from filing the forms on its own behalf.

 

(b) Any filing shall be made not less than forty-five (45) daysin advance of any delivery. At the expiration of forty-five (45) days the formfiled is approved unless affirmatively approved or disapproved by thecommissioner's order. Approval of any form by the commissioner constitutes awaiver of any unexpired portion of the waiting period. The commissioner mayextend by not more than an additional forty-five (45) days the period withinwhich he may affirmatively approve or disapprove any form, by giving notice tothe insurer of the extension before expiration of the initial forty-five (45)day period. At the expiration of any extended period, and in the absence ofprior affirmative approval or disapproval, any form is deemed approved. Thecommissioner, at any time, after notice and for cause shown, may withdraw anyapproval.

 

(c) Any order of the commissioner disapproving a form orwithdrawing a previous approval shall state the grounds and the particulars forthe withdrawal in such detail as to reasonably inform the insurer. Thewithdrawal of a previously approved form is effective at the expiration of theperiod the commissioner prescribes in the notice, but not less than thirty (30)days from the date of the notice.

 

(d) The commissioner, by order, may exempt from therequirements of this section for so long as he deems proper any insurancedocument or form or type thereof as specified in the order, to which, in hisopinion:

 

(i) This section may not practicably be applied;

 

(ii) The filing and approval of which are not desirable ornecessary for the public's protection; or

 

(iii) The document or form or type thereof has been approvedunder the provisions of the Interstate Insurance Product Regulation Compact asprovided in W.S. 26-15-201.

 

(e) Appeals from the commissioner's orders disapproving a formor withdrawing a previous approval may be taken as provided in W.S. 26-2-125through 26-2-129.

 

26-15-111. Filing and approval of application forms; grounds fordisapproval.

 

 

(a) The commissioner, within forty-five (45) days after filingof any insurance policy, shall disapprove any form filed under W.S. 26-15-110,or withdraw any previous approval thereof, only if:

 

(i) The form:

 

(A) Is in any respect in violation of or does not comply withthis code;

 

(B) Contains or incorporates by reference, if the incorporationis otherwise permissible, any inconsistent, ambiguous or misleading clauses, orexceptions and conditions which deceptively affect the risk purported to beassumed in the general coverage of the contract;

 

(C) Has any title, heading, or other indication of itsprovisions which is misleading; or

 

(D) Is printed or otherwise reproduced in such manner as torender any provision of the form substantially illegible; or

 

(ii) He finds that:

 

(A) The benefits provided in the policy are unreasonable inrelation to the premiums charged; or

 

(B) The rates or classification are excessive, inadequate orunfairly discriminatory. This paragraph does not apply to any policy form forinsurance except those lines of insurance deemed noncompetitive under W.S.26-14-101 through 26-14-118 [ 26-14-101 through26-14-119].

 

(b) If the commissioner disapproves the insurance policy, theinsurer may request a hearing pursuant to the Wyoming Administrative ProcedureAct.

 

26-15-112. Standard and uniform provisions of policies.

 

 

(a) Insurance contracts shall contain any standard or uniformprovisions required by the applicable provisions of this code pertaining tocontracts of particular kinds of insurance. The commissioner may waive therequired use of a particular provision in a particular insurance policy formif:

 

(i) He finds the provision unnecessary for the insured'sprotection and inconsistent with the policy's purposes; and

 

(ii) He otherwise approves the policy.

 

(b) No policy shall contain any provision inconsistent with orcontradictory to any standard or uniform provision used or required to be used,but the commissioner may approve any substitute provision which, in hisopinion, is not less favorable in any particular to the insured or beneficiarythan the provisions otherwise required.

 

(c) Instead of the provisions required by this code forcontracts for particular kinds of insurance, substantially similar provisionsrequired by the law of the domicile of a foreign or alien insurer may be usedif the commissioner approves.

 

(d) A policy issued by a domestic insurer for delivery inanother jurisdiction may contain any provision required or permitted by thelaws of that jurisdiction.

 

26-15-113. Contents of policies generally.

 

 

(a) Any policy shall specify:

 

(i) The names of the parties to the contract;

 

(ii) The subject of the insurance;

 

(iii) The risks insured against;

 

(iv) The time when the insurance thereunder takes effect and theperiod during which the insurance is to continue;

 

(v) The premium;

 

(vi) The conditions pertaining to the insurance;

 

(vii) Benefits payable, if a life or disability insurancecontract.

 

(b) The commissioner, by rule or regulation, may require a lifeinsurer to show in life insurance policies, by reasonable itemization thereof,the amount of premium charged for optional, unique or particular materialfeatures or benefits included in or with the policy. The commissioner may alsospecify what portion of the charge by the insurer for or in connection withtitle insurance shall be set forth in the policy.

 

(c) If under the policy the exact amount of premium isdeterminable only at stated intervals or upon termination of the contract, a statementof the basis and rates upon which the premium is to be determined and paidshall be included.

 

(d) Subsections (a) through (c) of this section do not apply tosurety contracts or to group insurance policies.

 

26-15-114. Additional policy contents.

 

 

(a) A policy may contain additional provisions not inconsistentwith this code and which are:

 

(i) Required to be inserted by the laws of the insurer'sdomicile;

 

(ii) Necessary, because of the manner in which the insurer isconstituted or operated, in order to state the rights and obligations of theparties to the contract; or

 

(iii) Desired by the insurer and neither prohibited by law nor inconflict with any provisions required to be included therein.

 

26-15-115. Adoption of charter and bylaws by reference prohibited.

 

Nopolicy shall contain any provision purporting to make any portion of thecharter, bylaws or other constituent document of the insurer, other than thesubscriber's agreement or power of attorney of a reciprocal insurer, a part ofthe contract unless that portion is set forth in full in the policy. Any policyprovision in violation of this section is invalid.

 

26-15-116. Execution of policies.

 

 

(a) Any insurance policy shall be executed in the name of andon behalf of the insurer by its authorized officer, attorney-in-fact, employeeor other representative.

 

(b) A facsimile signature of any executing individual may beused instead of an original signature.

 

(c) No insurance contract which is otherwise valid shall berendered invalid by reason of the apparent execution thereof on behalf of theinsurer by the imprinted facsimile signature of an individual not authorized toexecute as of the date of the policy.

 

26-15-117. Underwriters' and combination policies.

 

 

(a) Two (2) or more authorized insurers may jointly issue, andare jointly and severally liable on, an underwriters' policy bearing theirnames. Any insurer may issue a policy in the name of an underwriters'department, and the policy shall plainly show the insurer's true name.

 

(b) Two (2) or more insurers, with the commissioner's approval,may issue a combination policy which shall contain provisions substantially asfollows:

 

(i) That the insurers executing the policy are severally liablefor the full amount of any loss or damage, according to the terms of thepolicy, or for specified percentages or amounts thereof, aggregating the fullamount of insurance under the policy; and

 

(ii) That service of process or of any notice or proof of lossrequired by the policy, upon any of the insurers executing the policy,constitutes service upon all the insurers.

 

(c) This section does not apply to cosurety obligations.

 

26-15-118. Validity and construction of noncomplying policies.

 

 

(a) Any policy delivered or issued for delivery to any personin this state in violation of this code, but otherwise binding on the insurer,is valid, but shall be construed as provided in this code.

 

(b) Any condition, omission or provision not in compliance withthis code and contained in any policy, rider or endorsement, otherwise valid,is not thereby invalid but shall be construed and applied in accordance withthe condition, omission or provision as would have applied if it had been infull compliance with this code.

 

26-15-119. Binders and other contracts for temporary insurance.

 

 

(a) Binders or other contracts for temporary insurance may bemade orally or in writing and include all the usual terms of the policy as towhich the binder is given together with applicable endorsements as aredesignated in the binder, except as superseded by the terms of the binder.

 

(b) No binder is valid beyond the issuance of the policy withrespect to which it is given, or beyond ninety (90) days from its effectivedate, whichever period is shorter.

 

(c) If the policy is not issued, a binder may be extended orrenewed beyond the ninety (90) days with the commissioner's written approval orin accordance with rules and regulations relative thereto the commissionerpromulgates.

 

(d) This section does not apply to life or disabilityinsurances.

 

26-15-120. Delivery of policy; duplicate policies.

 

Ifthe original policy is delivered or is required to be delivered to or fordeposit with any vendor, mortgagee or pledgee of any motor vehicle, and inwhich policy any interest of the vendee, mortgagor or pledgor in or withreference to the vehicle is insured, a duplicate of the policy setting forththe name and address of the insurer, insurance classification of vehicle, typeof coverage, limits of liability, premiums for the types of coverage, andduration of the policy, or memorandum thereof containing the same information,shall be delivered by the vendor, mortgagee or pledgee to each vendee,mortgagor or pledgor named in the policy or coming within the group of personsdesignated in the policy to be included. If the policy does not providecoverage of legal liability for injury to persons or damage to the property ofthird parties, a statement of that fact shall be printed, written or stamped conspicuouslyon the face of the duplicate policy or memorandum. This section does not applyto inland marine floater policies.

 

26-15-121. Renewal by certificate or endorsement.

 

 

(a) Except as provided in subsection (b) of this section, anyinsurance policy terminating by its terms at a specified expiration date, andnot otherwise renewable, may be renewed or extended:

 

(i) At the insurer's option;

 

(ii) Upon a currently authorized policy form and at the premiumrate then required for the policy;

 

(iii) For a specific additional period by certificates or bypolicy endorsement; and

 

(iv) Without requiring the issuance of a new policy.

 

(b) A private health benefit plan as defined in W.S.26-1-102(a)(xxxiii), shall be renewable with respect to all insureds at theoption of the insured except in the following cases:

 

(i) Nonpayment of the required premiums;

 

(ii) Fraud or misrepresentation by the insured; or

 

(iii) In the event the insurer elects not to renew an individualprivate health insurance plan, it may do so only if it elects not to renew allof its individual private health insurance benefit plans issued in this state. In the event the insurer elects not to renew a group private health benefitplan, it may do so only if it elects not to renew all of its group privatehealth benefit plans issued in this state. In either case, the insurer shall:

 

(A) Provide notice of the decision not to renew coverage to allaffected private health benefit plans and to all affected individually insuredpersons at least one hundred eighty (180) days prior to the nonrenewal of allhealth benefit plans by the insurer; and

 

(B) Provide notice of its decision under this paragraph to thecommissioner at least three (3) working days prior to providing the noticerequired under subparagraph (A) of this paragraph.

 

26-15-122. Assignment of policies.

 

Apolicy is assignable or not assignable as provided by its terms. Subject to itsterms relating to assignability, any life or disability policy, under the termsof which the beneficiary may be changed upon the sole request of the insured orowner, may be assigned either by pledge or transfer of title, by an assignmentexecuted by the insured or owner alone and delivered to the insurer, whether ornot the pledgee or assignee is the insurer. The assignment entitles the insurerto deal with the assignee as the owner or pledgee of the policy in accordancewith the terms of the assignment, until the insurer receives at its home officewritten notice of termination of the assignment or pledge, or written notice byor on behalf of some other person claiming some interest in the policy inconflict with the assignment.

 

26-15-123. Payment discharges insurer.

 

Ifthe proceeds of or payments under any life or disability insurance policy orannuity contract are payable in accordance with the terms of the policy orcontract, or the exercise of any right or privilege thereunder, and the insurermakes payment thereof in accordance with those terms or in accordance with anywritten assignment thereof, the person then designated as being entitledthereto is entitled to receive the proceeds or payments and to give fullacquittance therefor. The payments fully discharge the insurer from all claimsunder the policy or contract unless, before payment is made, the insurerreceives at its home office written notice by or on behalf of some other personthat the other person claims to be entitled to the payment or some interest inthe policy or contract.

 

26-15-124. Claim to be accepted or rejected; attorney's fee.

 

 

(a) Claims for benefits under a life, accident or healthinsurance policy shall be rejected or accepted and paid by the insurer or itsagent designated to receive the claims within forty-five (45) days afterreceipt of the proofs of loss and supporting evidence. Exceptions to the timeof forty-five (45) days shall be made for accident and health insurance claimsif there is any question as to the validity or the amount of the claim and thequestion is referred to the Wyoming state medical peer review committee foradjudication.

 

(b) Claims for benefits under a property or casualty insurancepolicy shall be rejected or accepted and paid by the insurer or its agentdesignated to receive those claims within forty-five (45) days after receipt ofthe claim and supporting bills.

 

(c) In any actions or proceedings commenced against anyinsurance company on any insurance policy or certificate of any type or kind ofinsurance, or in any case where an insurer is obligated by a liability insurancepolicy to defend any suit or claim or pay any judgment on behalf of a namedinsured, if it is determined that the company refuses to pay the full amount ofa loss covered by the policy and that the refusal is unreasonable or withoutcause, any court in which judgment is rendered for a claimant may also award areasonable sum as an attorney's fee and interest at ten percent (10%) per year.

 

26-15-125. Repealed by Laws 1993, ch. 1, 2.

 

26-15-126. Forms for proof of loss to be furnished.

 

Aninsurer, upon written request of any person claiming to have a loss under aninsurance contract issued by that insurer, shall furnish forms of proof of lossfor completion by the person. The insurer, because of the requirement tofurnish forms, does not have any responsibility for or with reference to thecompletion of the proof or the manner of any completion or attemptedcompletion.

 

26-15-127. Uniform health insurance claim forms.

 

Thecommissioner shall prescribe uniform health insurance claim forms and formatsfor governmental agencies and health care providers as defined by W.S.26-40-102(a)(i), which, after January 1, 1997, shall be used by all insurerstransacting health insurance in this state and by all governmental agencies andhealth care providers of this state that require health insurance claim formsor formats for their records.

 

26-15-128. Insurer's acts not constituting waiver of policy provisionsor defenses.

 

 

(a) None of the following acts by or on behalf of an insurerconstitutes a waiver of any provision of a policy, or of any right, or of anydefense of the insurer thereunder or otherwise:

 

(i) Acknowledgment of the receipt of notice of loss or claimunder the policy;

 

(ii) Furnishing forms for reporting a loss or claim, for givinginformation relative thereto, or for making proof of loss, or receiving oracknowledging receipt of the forms or proofs completed or uncompleted;

 

(iii) Investigating any loss or claim under any policy orengaging in negotiations looking toward a possible settlement of any such lossor claim.

 

26-15-129. Exemption of proceeds; life insurance.

 

(a) If a policy of insurance is executed by any person on hisown life or on another life, in favor of a person other than himself, or exceptin cases of transfer with intent to defraud creditors, if a policy of lifeinsurance is assigned or in any way made payable to that person, the lawfulbeneficiary or assignee thereof, other than the insured or the person executinginsurance or executors or administrators of the insured or the person executingthe insurance, are entitled to its proceeds, including death benefits, cashsurrender and loan values, premiums waived and dividends, whether used inreduction of premiums or otherwise, excepting only where the debtor, subsequentto issuance of the policy, has actually elected to receive the dividends incash, against the creditors and representatives of the insured and of theperson executing the policy, and are not liable to be applied by any legal orequitable process to pay any debt or liability of the insured individual or hisbeneficiary or of any other person having a right under the policy, whether ornot:

 

(i) The right to change the beneficiary is reserved orpermitted; and

 

(ii) The policy is made payable to the person whose life isinsured if the beneficiary or assignee predeceases that person, and theproceeds are exempt from all liability for any debt of the beneficiary existingat the time the policy is made available for his use.

 

(b) However, subject to the statute of limitations, the amountof any premiums paid for insurance with intent to defraud creditors, withinterest thereon, shall inure to their benefit from the policy proceeds; butthe insurer issuing the policy is discharged of all liability thereon bypayment of its proceeds in accordance with its terms, unless before payment theinsurer receives written notice at its home office, by or in behalf of acreditor of:

 

(i) A claim to recover for transfer made or premiums paid withintent to defraud creditors;

 

(ii) The amount claimed along with facts as will assist theinsurer to ascertain the particular policy.

 

(c) For the purposes of subsections (a) and (b) of thissection, a policy is payable to a person other than the insured if and to theextent that a facility-of-payment clause or similar clause in the policypermits the insurer to discharge its obligation after the death of theindividual insured by paying the death benefits to a person as permitted by theclause.

 

26-15-130. Exemption of proceeds; disability insurance.

 

Exceptas otherwise provided by the policy or contract, the proceeds of all contractsof disability insurance and of provisions specifying benefits because of theinsured's disability, which are supplemental to any life insurance or annuitycontracts executed, are exempt from all liability for any debt of the insuredand from any debt of the beneficiary existing at the time the proceeds are madeavailable for his use.

 

26-15-131. Exemption of proceeds; group insurance.

 

(a) A policy of group life insurance or group disabilityinsurance or the proceeds thereof, including death benefits, cash surrender andloan values, premiums waived and dividends, whether used in reduction ofpremiums or otherwise, excepting only where the debtor, subsequent to issuanceof the policy, has actually elected to receive the dividends in cash, payableto the individual insured or to the named beneficiary are not liable to beapplied by any legal or equitable process to pay any debt or liability of theinsured individual or his beneficiary or of any other person having a rightunder the policy. The proceeds, when not made payable to a named beneficiary,or to a third person pursuant to a facility-of-payment clause, do notconstitute a part of the insured individual's estate for the payment of hisdebts.

 

(b) This section does not apply to group insurance issuedpursuant to this code to a creditor covering his debtors, to the extent thatthe proceeds are applied to payment of the obligation for the purpose of whichthe insurance is issued.

 

26-15-132. Exemption of proceeds; annuity contracts; assignability ofrights.

 

 

(a) The benefits, rights, privileges and options which underany annuity contract issued are due or prospectively due the annuitant, are notsubject to execution nor is the annuitant compelled to exercise any suchrights, powers or options. Creditors are not allowed to interfere with orterminate the contract, except:

 

(i) As to amounts paid for or as premium on the annuity withintent to defraud creditors, with interest thereon, and of which the creditorgives the insurer written notice at its home office prior to the making of thepayment to the annuitant out of which the creditor seeks to recover, whichnotice shall specify:

 

(A) The amount claimed or facts to enable the ascertainment ofthe amount; and

 

(B) Facts to enable the insurer to ascertain the annuitycontract, the annuitant and the payment sought to be avoided on the ground offraud.

 

(ii) The total exemption of benefits presently due and payableto any annuitant periodically or at stated times under all annuity contractsunder which he is an annuitant shall not at any time exceed three hundred fiftydollars ($350.00) per month for the length of time represented by theinstallments, and any periodic payments in excess of three hundred fiftydollars ($350.00) per month are subject to garnishee execution to the sameextent as are wages and salaries;

 

(iii) If the total benefits presently due and payable to any annuitantunder any annuity contracts at any time exceed three hundred fifty dollars($350.00) per month, the court may order the annuitant to pay to a judgmentcreditor or apply on the judgment, in installments, that portion of the excessbenefits as to the court appear just and proper, after regard for thereasonable requirements of the judgment debtor and his family, if dependentupon him, as well as any payments required to be made by the annuitant to othercreditors under prior court order.

 

(b) If the contract provides, the benefits, rights, privilegesor options accruing under that contract to a beneficiary or assignee are nottransferable nor subject to commutation, and if the benefits are payableperiodically or at stated times, the same exemptions and exceptions containedin this section for the annuitant, apply to the beneficiary or assignee.

 

26-15-133. Retention of proceeds of policy by company.

 

 

(a) Any life insurer may hold the proceeds of any life orendowment insurance or annuity contract it issues:

 

(i) Upon the terms and restrictions as to revocation by theinsured and control by beneficiaries;

 

(ii) With the exemptions from legal process and the claims ofcreditors of beneficiaries, other than the insured; and

 

(iii) Upon any other terms and conditions, regardless of the timeand manner of payment of proceeds, agreed to in writing by the insurer and theinsured or beneficiary.

 

(b) The insurer is not required to segregate funds held undersubsection (a) of this section but may hold them as a part of its generalcorporate assets.

 

(c) The provisions of this section do not impair or affect anyrights of creditors under W.S. 26-15-129 or 26-15-132.

 

26-15-134. Venue of suits against insurers.

 

Suitupon causes of action arising within this state against an insurer over aninsurance contract shall be brought in the county where the cause of actionarose or in the county where the policyholder instituting the action resides.

 

26-15-135. Coverage of children.

 

(a) No insurance company, multi-employer trust or otherprovider of an individual, group or blanket health insurance product in thisstate shall:

 

(i) Refuse to accept and honor an otherwise valid claim for acovered service which is filed by either parent of a covered child, or by thedepartment of family services in the case of an assignment under W.S. 20-6-106,who submits valid copies of medical bills;

 

(ii) Refuse to provide medical insurance coverage of a childunder the health plan of the child's parent on the grounds that:

 

(A) The child was born out of wedlock;

 

(B) The child is not claimed as a dependent on the parent'sfederal tax return; or

 

(C) The child does not reside with the parent or in theinsurer's service area.

 

(iii) Refuse to provide medical insurance coverage for anotherwise insurable child under the policy if the child for whom the claim ismade is presumed to be the natural child of the insured under W.S. 14-2-504 or14-2-822.

 

(b) Where a child has health coverage through an insurer of anoncustodial parent or a parent sharing custody or temporary control of thechild the insurer shall:

 

(i) Provide such information to either parent sharing custodyor temporary control of the child as may be necessary for the child to obtainbenefits through that coverage;

 

(ii) Permit either parent sharing custody or temporary controlof the child, or the provider with either parent's approval, to submit claimsfor covered services without the approval of the other parent; and

 

(iii) Make payments on claims submitted in accordance withparagraph (ii) of this subsection directly to the parent who paid for theservices, the provider or the department of health as administrator of theWyoming Medical Assistance and Services Act.

 

(c) Where a parent is required by a court or administrativeorder to provide health coverage for a child and the parent is eligible forfamily health coverage, the insurer shall be required:

 

(i) To permit the parent to enroll under the family coverage, achild who is otherwise eligible for the coverage without regard to anyenrollment season restrictions;

 

(ii) If the parent is enrolled but fails to make application toobtain coverage for the child, to enroll the child under family coverage uponapplication of the child's other parent, the department of health inadministering the Wyoming Medical Assistance and Services Act, or thedepartment of family services in administering the child support enforcementprogram;

 

(iii) To complete and return the plan administrator response inconjunction with the national medical support notice to the department offamily services within forty (40) business days after the date of the notice;and

 

(iv) Not to disenroll or eliminate coverage of the child unlessthe insurer is provided satisfactory written evidence that:

 

(A) The court or administrative order is no longer in effect;or

 

(B) The child is or will be enrolled in comparable healthcoverage through another insurer which will take effect not later than theeffective date of disenrollment.

 

(d) An insurer may not impose requirements on a state agency,which has been assigned the rights of an individual eligible for medicalassistance under the Wyoming Medical Assistance and Services Act and coveredfor health benefits from the insurer, that are different from requirementsapplicable to an agent or assignee of any other individual so covered.

 

26-15-136. Assignment of insurance proceeds to doctor, hospital orstate agency; lien for state care; notice of lien.

 

 

(a) Whenever a contract by a third party agency provides forpayment to a beneficiary under the contract for expenses incurred by him formedical, surgical or hospital care, the beneficiary shall assign the benefitsof the contract to the Wyoming department of health or any doctor or hospital,or other practitioner rendering the care in an amount equal to the value of thecare rendered. Notification sent by registered or certified mail to the thirdparty agency, with a copy to the insured, shall provide authority for the paymentdirectly by the third party agency to the assignee. The state shall have alien, in an amount equal to the care rendered, on the proceeds of the contractsfor care rendered by any hospital, institution or other facility, writtennotice of which shall provide authority for payment directly by the third partyagency to the state.

 

(b) Whenever there is in existence a contract between aninsurer and an insured for payment to, or on behalf of, an applicant orrecipient of medical assistance under the contract for expenses incurred by theapplicant or recipient for medical services, including physician services,nursing services, pharmaceutical services, surgical care and hospital care, theassignment of the benefits of the contract by the applicant or recipient or alegally liable party shall, upon receipt of notice from the assignee, provideauthority for payment by the insurer directly to the assignee. If notice isprovided by the assignee to the insurer in accordance with the provisions ofW.S 42-4-204, the insurer shall be liable to the assignee for any amountpayable to the assignee under the contract.

 

ARTICLE 2 - INTERSTATE INSURANCE PRODUCT REGULATION

 

26-15-201. Interstate insurance product regulation compact.

 

The Interstate Insurance Product Regulation Compact ishereby enacted into law and entered into on behalf of this state with any andall other states legally joining therein in a form substantially as follows:

 

INTERSTATE INSURANCE PRODUCT REGULATIONCOMPACT

 

ARTICLEI

 

Purposes

 

(a) The purposes of this compact are, through means ofjoint and cooperative action among the compacting states:

 

(i) To promote and protect theinterest of consumers of individual and group annuity, life insurance,disability income and long-term care insurance products;

 

(ii) To develop uniform standardsfor insurance products covered under the compact;

 

(iii) To establish a centralclearinghouse to receive and provide prompt review of insurance productscovered under the compact and, in certain cases, advertisements relatedthereto, submitted by insurers authorized to do business in one or morecompacting states;

 

(iv) To give appropriateregulatory approval to those product filings and advertisements satisfying theapplicable uniform standard;

 

(v) To improve coordination of regulatory resources andexpertise between state insurance departments regarding the setting of uniformstandards and review of insurance products covered under the compact;

 

(vi) To create the interstate insurance product regulationcommission; and

 

(vii) To perform these and suchother related functions as may be consistent with the state regulation of thebusiness of insurance.

 

ARTICLE II

 

Definitions

 

(a) Notwithstanding W.S. 26-1-102, for purposes of this compact:

 

(i) "Advertisement" means any material designedto create public interest in a product, or induce the public to purchase,increase, modify, reinstate, borrow on, surrender, replace or retain a policy,as more specifically defined in the rules and operating procedures of thecommission;

 

(ii) "Bylaws" meansthose bylaws established by the commission for its governance, or for directingor controlling the commission's actions or conduct;

 

(iii) "Compacting state" means any state whichhas enacted this compact legislation and which has not withdrawn pursuant toarticle XIV, section 1, or been terminated pursuant to article XIV, section 2;

 

(iv) "Commission" means the "interstateinsurance product regulation commission" established by this compact;

 

(v) "Commissioner" means the chief insuranceregulatory official of a state including, but not limited to commissioner,superintendent, director or administrator;

 

(vi) "Domiciliary state" means the state inwhich an insurer is incorporated or organized or, in the case of an alieninsurer, its state of entry;

 

(vii) "Insurer" meansany entity licensed by a state to issue contracts of insurance for any of thelines of insurance covered by this compact;

 

(viii) "Member" meansthe person chosen by a compacting state as its representative to thecommission, or his or her designee;

 

(ix) "Noncompacting state" means any state whichis not at the time a compacting state;

 

(x) "Operatingprocedures" mean procedures promulgated by the commission implementing arule, uniform standard or a provision of this compact;

 

(xi) "Product" means theform of a policy or contract, including any application, endorsement or relatedform which is attached to and made a part of the policy or contract, and anyevidence of coverage or certificate, for an individual or group annuity, lifeinsurance, disability income or long-term care insurance product that aninsurer is authorized to issue;

 

(xii) "Rule" means astatement of general or particular applicability and future effect promulgatedby the commission, including a uniform standard developed pursuant to articleVII of this compact, designed to implement, interpret or prescribe law orpolicy or describing the organization, procedure or practice requirements ofthe commission, which shall have the force and effect of law in the compactingstates;

 

(xiii) "State" means any state, district or territory of the United Statesof America;

 

(xiv) "Third-party filer" means an entity that submits a product filing tothe commission on behalf of an insurer;

 

(xv) "Uniform standard" means a standard adopted by the commission for aproduct line, pursuant to article VII of this compact, and shall include all ofthe product requirements in aggregate, provided, that each uniform standardshall be construed, whether express or implied, to prohibit the use of anyinconsistent, misleading or ambiguous provisions in a product and the form ofthe product made available to the public shall not be unfair, inequitable oragainst public policy as determined by the commission.

 

ARTICLEIII

 

Establishmentof the commission and venue

 

(a) Thecompacting states hereby create and establish a joint public agency known asthe "interstate insurance product regulation commission." Pursuantto article IV, the commission will have the power to develop uniform standardsfor product lines, receive and provide prompt review of products filedtherewith and give approval to those product filings satisfying applicableuniform standards; provided, it is not intended for the commission to be theexclusive entity for receipt and review of insurance product filings. Nothingherein shall prohibit any insurer from filing its product in any state whereinthe insurer is licensed to conduct the business of insurance; and any suchfiling shall be subject to the laws of the state where filed.

 

(b) Thecommission is a body corporate and politic, and an instrumentality of thecompacting states.

 

(c) The commission is solely responsible for itsliabilities except as otherwise specifically provided in this compact.

 

(d) Venueis proper and judicial proceedings by or against the commission shall bebrought solely and exclusively in a court of competent jurisdiction where theprincipal office of the commission is located.

 

ARTICLEIV

 

Powersof the commission

 

(a) Thecommission shall have the following powers:

 

(i) Topromulgate rules, pursuant to article VII of this compact, which shall have theforce and effect of law and shall be binding in the compacting states to theextent and in the manner provided in this compact;

 

(ii) To exercise its rulemakingauthority and establish reasonable uniform standards for products covered underthe compact, and advertisement related thereto, which shall have the force andeffect of law and shall be binding in the compacting states, but only for thoseproducts filed with the commission, provided, that a compacting state shallhave the right to opt out of such uniform standard pursuant to article VII, tothe extent and in the manner provided in this compact, and, provided further,that any uniform standard established by the commission for long-term careinsurance products may provide the same or greater protections for consumersas, but shall not provide less than, those protections set forth in theNational Association of Insurance Commissioners' Long-Term Care Insurance ModelAct and Long-Term Care Insurance Model Regulation, respectively, adopted as of2001. The commission shall consider whether any subsequent amendments to theNational Association Of Insurance Commissioners' Long-Term Care Insurance ModelAct or Long-Term Care Insurance Model Regulation adopted by the nationalassociation of insurance commissioners require amending of the uniformstandards established by the commission for long-term care insurance products;

 

(iii) To receive and review in anexpeditious manner products filed with the commission, and rate filings fordisability income and long-term care insurance products, and give approval ofthose products and rate filings that satisfy the applicable uniform standard,where such approval shall have the force and effect of law and be binding onthe compacting states to the extent and in the manner provided in the compact;

 

(iv) To receive and review in anexpeditious manner advertisement relating to long-term care insurance productsfor which uniform standards have been adopted by the commission, and giveapproval to all advertisement that satisfies the applicable uniform standard. For any product covered under this compact, other than long-term care insuranceproducts, the commission shall have the authority to require an insurer tosubmit all or any part of its advertisement with respect to that product forreview or approval prior to use, if the commission determines that the natureof the product is such that an advertisement of the product could have thecapacity or tendency to mislead the public. The actions of commission asprovided in this section shall have the force and effect of law and shall bebinding in the compacting states to the extent and in the manner provided inthe compact;

 

(v) To exercise its rulemakingauthority and designate products and advertisement that may be subject to aself-certification process without the need for prior approval by thecommission;

 

(vi) To promulgate operatingprocedures, pursuant to article VII of this compact, which shall be binding inthe compacting states to the extent and in the manner provided in this compact;

 

(vii) To bringand prosecute legal proceedings or actions in its name as the commission;provided, that the standing of any state insurance department to sue or be suedunder applicable law shall not be affected;

 

(viii) To issue subpoenas requiring the attendance andtestimony of witnesses and the production of evidence;

 

(ix) To establishand maintain offices;

 

(x) To purchaseand maintain insurance and bonds;

 

(xi) To borrow, accept or contract for services ofpersonnel, including, but not limited to, employees of a compacting state;

 

(xii) To hire employees,professionals or specialists, and elect or appoint officers, and to fix theircompensation, define their duties and give them appropriate authority to carryout the purposes of the compact, and determine their qualifications; and toestablish the commission's personnel policies and programs relating to, amongother things, conflicts of interest, rates of compensation and qualificationsof personnel;

 

(xiii) To accept any and allappropriate donations and grants of money, equipment, supplies, materials andservices, and to receive, utilize and dispose of the same; provided that at alltimes the commission

State Codes and Statutes

Statutes > Wyoming > Title26 > Chapter15

CHAPTER 15 - THE INSURANCE CONTRACT

 

ARTICLE 1 - IN GENERAL

 

26-15-101. Scope of chapter.

 

 

(a) This chapter applies to all insurance contracts and annuitycontracts except:

 

(i) Reinsurance;

 

(ii) Policies or contracts not issued for delivery in this statenor delivered in this state;

 

(iii) Wet marine and transportation insurance.

 

26-15-102. Life insurance upon individual or person in whom he hasinsurable interest; "insurable interest" defined.

 

 

(a) Any individual of competent legal capacity may procure oreffect an insurance contract upon his own life or body for the benefit of anyperson. Except as provided in W.S. 26-15-103, no person shall procure or causeto be procured any insurance contract upon the life or body of anotherindividual unless the benefits under the contract are payable to the individualinsured or his personal representatives, or to a person having, at the timewhen the contract is made, an insurable interest in the individual insured.

 

(b) If the beneficiary, assignee or other payee under anycontract made in violation of this section receives from the insurer anybenefits thereunder accruing upon the death, disablement or injury of theindividual insured, the individual insured or his executor or administrator, asthe case may be, may maintain an action to recover the benefits from the personreceiving them.

 

(c) "Insurable interest" as to personal insurancemeans that any individual has an insurable interest in the life, body andhealth of himself, and of other persons as follows:

 

(i) In the case of individuals related closely by blood or bylaw, a substantial interest engendered by love and affection;

 

(ii) In the case of other persons, a lawful and substantialeconomic interest in having the life, health or bodily safety of the individualinsured continue, as distinguished from an interest arising only by, orenhanced in value by, the death, disablement or injury of the individualinsured; and

 

(iii) An individual party to a contract or option for thepurchase or sale of an interest in a business partnership or firm, or of sharesof stock of a closed corporation or of an interest in those shares, has aninsurable interest in the life of each individual party to the contract and forthe purposes of the contract only, in addition to any insurable interest whichotherwise exists as to that individual's life.

 

(d) An insurer may rely upon all statements, declarations andrepresentations made by an applicant for insurance relative to the applicant'sinsurable interest in the insured. No insurer incurs legal liability, except asset forth in the policy, by virtue of any untrue statements, declarations orrepresentations relied upon in good faith.

 

26-15-103. Life insurance for benefit of charitable institutions.

 

 

(a) Contracts of life insurance may be made and entered into inwhich the person paying the consideration for the insurance has no insurableinterest in the life of the person insured, if charitable, benevolent,educational or religious institutions are designated irrevocably as abeneficiary but not necessarily the primary beneficiary thereof.

 

(b) In making a contract as specified in subsection (a) of thissection, the person paying the premium shall make and sign the applicationtherefor as owner and shall designate a charitable, benevolent, educational orreligious institution irrevocably as the beneficiary or one (1) of thebeneficiaries of the policy. The application also shall be signed by the personwhose life is to be insured.

 

(c) The contract is valid and binding among all of the partiesthereto, notwithstanding that the owner has no insurable interest in the lifeof the person insured.

 

26-15-104. Insurable interest in property; "insurableinterest" defined.

 

 

(a) No contract of insurance of property or of any interest inproperty or arising from property is enforceable as to the insurance except forthe benefit of persons having an insurable interest in the things insured atthe time of the loss.

 

(b) The measure of an insurable interest in property is theextent to which the insured might be directly or indirectly damnified by lossor impairment thereof.

 

(c) "Insurable interest" as used in this sectionmeans any actual, lawful and substantial economic interest in the safety orpreservation of the subject of the insurance free from loss, destruction orpecuniary damage or impairment.

 

26-15-105. Purchase of life insurance by or for minors or any person ofcompetent legal capacity.

 

 

(a) Any person of competent legal capacity may contract forinsurance.

 

(b) Any minor not less than fifteen (15) years of age,notwithstanding his minority, may contract for or own annuities, or insurance,or affirm by novation or otherwise preexisting contracts for annuities orinsurance upon his own life, body, health, property, liabilities or otherinterests, or on the person of another in whom the minor has an insurableinterest. The minor, notwithstanding his minority, may exercise all rights andpowers with respect to or under any contract for annuity or for insurance uponhis own life, body or health, or any contract the minor effects upon his ownproperty, liabilities or other interests, or any contract the minor owns oreffects on the person of another, as might be exercised by a person of fulllegal age, and may at any time surrender his interest in any such contracts andgive valid discharge for any benefit accruing or money payable thereunder. Theminor, by reason of his minority, is not entitled to rescind, avoid orrepudiate the contract, nor to rescind, avoid or repudiate any exercise of aright or privilege thereunder, except that such a minor not otherwiseemancipated is not bound by any unperformed agreement to pay, by promissorynote or otherwise, any premium on any such annuity or insurance contract.

 

(c) Any annuity contract or policy of life disability insuranceprocured by or for a minor under subsection (b) of this section, shall be madepayable either to the minor or his estate or to a person having an insurableinterest in the minor's life.

 

26-15-106. Application to be made by individual insured; exceptions.

 

 

(a) No life or disability insurance contract upon anindividual, except a contract of group life insurance or of group or blanketdisability insurance, shall be made or carried out unless at the time of themaking of the contract the individual insured, being of competent legalcapacity to contract, applies therefor or has consented thereto in writing,except:

 

(i) A spouse may carry out the insurance upon the other spouse;

 

(ii) Any person having an insurable interest in the life of aminor, or any person upon whom a minor is dependent for support andmaintenance, may carry out insurance upon the life of or pertaining to theminor;

 

(iii) Family policies may be issued insuring any two (2) or moremembers of a family on an application signed by either parent, a stepparent orby a husband or wife.

 

26-15-107. Alteration of application prohibited; exceptions.

 

Noalteration of any written application for any life or disability insurancepolicy shall be made by any person other than the applicant without his writtenconsent, except that the insurer may make insertions for administrativepurposes only in a manner as to indicate clearly that the insertions are not tobe ascribed to the applicant.

 

26-15-108. Application as evidence.

 

 

(a) No application for the issuance of any life or disabilityinsurance policy or annuity contract is admissible in evidence in any actionrelative to the policy or contract, unless a true copy of the application isattached to or otherwise made a part of the policy or contract when issued.This provision does not apply to industrial life insurance policies.

 

(b) If any life or disability insurance policy delivered inthis state is reinstated or renewed, and the insured or the policy beneficiaryor assignee makes written request to the insurer for a copy of thereinstatement or renewal application, if any, the insurer, within thirty (30)days after receipt of the request at its home office, shall deliver or mail tothe person making the request a copy of the application reproduced by anylegible means. If the copy is not delivered or mailed after having beenrequested, the insurer is precluded from introducing the application in evidencein any action or proceeding based upon or involving the policy or itsreinstatement or renewal. In the case of a request from a beneficiary, the timewithin which the insurer is required to furnish a copy of the application doesnot begin to run until after receipt of evidence satisfactory to the insurer ofthe beneficiary's vested interest in the policy or contract.

 

(c) As to insurance other than life or disability insurance, noapplication for insurance signed by or on behalf of the insured is admissiblein evidence in any action between the insured and the insurer arising out ofthe policy so applied for, if the insurer fails, at expiration of thirty (30)days after receipt of written demand therefor by or on behalf of the insured,to furnish to the insured a copy of the application reproduced by any legiblemeans.

 

26-15-109. Statements in applications as representations and not aswarranties; misrepresentations.

 

 

(a) Any statements and descriptions in any application for aninsurance policy or annuity contract, by or in behalf of the insured orannuitant, are representations and not warranties. Misrepresentations,omissions, concealment of facts and incorrect statements do not prevent arecovery under the policy or contract unless either:

 

(i) Fraudulent; or

 

(ii) Material either to the acceptance of the risk, or to thehazard the insurer assumes; or

 

(iii) The insurer in good faith, if it knew the true facts asrequired by the application for the policy or contract or otherwise, would nothave:

 

(A) Issued the policy or contract;

 

(B) Issued it at the same premium rate;

 

(C) Issued a policy or contract in as large an amount; or

 

(D) Provided coverage with respect to the hazard resulting inthe loss.

 

26-15-110. Filing and approval of application forms.

 

(a) No basic insurance policy or annuity contract form, orapplication form if written application is required and is to be made a part ofthe policy or contract, or printed rider or endorsement form or form of renewalcertificate, shall be delivered or issued for delivery in this state unless theform is filed with and approved by the commissioner or is approved as providedin W.S. 26-15-201. This provision does not apply to surety bonds, or tospecially rated inland marine risks, nor to policies, riders, endorsements orforms of unique character designed for and used with relation to insurance upona particular subject, or which relate to the manner of distribution of benefitsor to the reservation of rights and benefits under life or disability insurancepolicies and are used at the request of the individual policyholder, contractholder or certificate holder. As to forms for use in property, marine, otherthan wet marine and transportation insurance, casualty and surety insurance coverages,the filing required by this subsection may be made by advisory and ratingorganizations on behalf of their members and subscribers. This provision doesnot prohibit any member or subscriber from filing the forms on its own behalf.

 

(b) Any filing shall be made not less than forty-five (45) daysin advance of any delivery. At the expiration of forty-five (45) days the formfiled is approved unless affirmatively approved or disapproved by thecommissioner's order. Approval of any form by the commissioner constitutes awaiver of any unexpired portion of the waiting period. The commissioner mayextend by not more than an additional forty-five (45) days the period withinwhich he may affirmatively approve or disapprove any form, by giving notice tothe insurer of the extension before expiration of the initial forty-five (45)day period. At the expiration of any extended period, and in the absence ofprior affirmative approval or disapproval, any form is deemed approved. Thecommissioner, at any time, after notice and for cause shown, may withdraw anyapproval.

 

(c) Any order of the commissioner disapproving a form orwithdrawing a previous approval shall state the grounds and the particulars forthe withdrawal in such detail as to reasonably inform the insurer. Thewithdrawal of a previously approved form is effective at the expiration of theperiod the commissioner prescribes in the notice, but not less than thirty (30)days from the date of the notice.

 

(d) The commissioner, by order, may exempt from therequirements of this section for so long as he deems proper any insurancedocument or form or type thereof as specified in the order, to which, in hisopinion:

 

(i) This section may not practicably be applied;

 

(ii) The filing and approval of which are not desirable ornecessary for the public's protection; or

 

(iii) The document or form or type thereof has been approvedunder the provisions of the Interstate Insurance Product Regulation Compact asprovided in W.S. 26-15-201.

 

(e) Appeals from the commissioner's orders disapproving a formor withdrawing a previous approval may be taken as provided in W.S. 26-2-125through 26-2-129.

 

26-15-111. Filing and approval of application forms; grounds fordisapproval.

 

 

(a) The commissioner, within forty-five (45) days after filingof any insurance policy, shall disapprove any form filed under W.S. 26-15-110,or withdraw any previous approval thereof, only if:

 

(i) The form:

 

(A) Is in any respect in violation of or does not comply withthis code;

 

(B) Contains or incorporates by reference, if the incorporationis otherwise permissible, any inconsistent, ambiguous or misleading clauses, orexceptions and conditions which deceptively affect the risk purported to beassumed in the general coverage of the contract;

 

(C) Has any title, heading, or other indication of itsprovisions which is misleading; or

 

(D) Is printed or otherwise reproduced in such manner as torender any provision of the form substantially illegible; or

 

(ii) He finds that:

 

(A) The benefits provided in the policy are unreasonable inrelation to the premiums charged; or

 

(B) The rates or classification are excessive, inadequate orunfairly discriminatory. This paragraph does not apply to any policy form forinsurance except those lines of insurance deemed noncompetitive under W.S.26-14-101 through 26-14-118 [ 26-14-101 through26-14-119].

 

(b) If the commissioner disapproves the insurance policy, theinsurer may request a hearing pursuant to the Wyoming Administrative ProcedureAct.

 

26-15-112. Standard and uniform provisions of policies.

 

 

(a) Insurance contracts shall contain any standard or uniformprovisions required by the applicable provisions of this code pertaining tocontracts of particular kinds of insurance. The commissioner may waive therequired use of a particular provision in a particular insurance policy formif:

 

(i) He finds the provision unnecessary for the insured'sprotection and inconsistent with the policy's purposes; and

 

(ii) He otherwise approves the policy.

 

(b) No policy shall contain any provision inconsistent with orcontradictory to any standard or uniform provision used or required to be used,but the commissioner may approve any substitute provision which, in hisopinion, is not less favorable in any particular to the insured or beneficiarythan the provisions otherwise required.

 

(c) Instead of the provisions required by this code forcontracts for particular kinds of insurance, substantially similar provisionsrequired by the law of the domicile of a foreign or alien insurer may be usedif the commissioner approves.

 

(d) A policy issued by a domestic insurer for delivery inanother jurisdiction may contain any provision required or permitted by thelaws of that jurisdiction.

 

26-15-113. Contents of policies generally.

 

 

(a) Any policy shall specify:

 

(i) The names of the parties to the contract;

 

(ii) The subject of the insurance;

 

(iii) The risks insured against;

 

(iv) The time when the insurance thereunder takes effect and theperiod during which the insurance is to continue;

 

(v) The premium;

 

(vi) The conditions pertaining to the insurance;

 

(vii) Benefits payable, if a life or disability insurancecontract.

 

(b) The commissioner, by rule or regulation, may require a lifeinsurer to show in life insurance policies, by reasonable itemization thereof,the amount of premium charged for optional, unique or particular materialfeatures or benefits included in or with the policy. The commissioner may alsospecify what portion of the charge by the insurer for or in connection withtitle insurance shall be set forth in the policy.

 

(c) If under the policy the exact amount of premium isdeterminable only at stated intervals or upon termination of the contract, a statementof the basis and rates upon which the premium is to be determined and paidshall be included.

 

(d) Subsections (a) through (c) of this section do not apply tosurety contracts or to group insurance policies.

 

26-15-114. Additional policy contents.

 

 

(a) A policy may contain additional provisions not inconsistentwith this code and which are:

 

(i) Required to be inserted by the laws of the insurer'sdomicile;

 

(ii) Necessary, because of the manner in which the insurer isconstituted or operated, in order to state the rights and obligations of theparties to the contract; or

 

(iii) Desired by the insurer and neither prohibited by law nor inconflict with any provisions required to be included therein.

 

26-15-115. Adoption of charter and bylaws by reference prohibited.

 

Nopolicy shall contain any provision purporting to make any portion of thecharter, bylaws or other constituent document of the insurer, other than thesubscriber's agreement or power of attorney of a reciprocal insurer, a part ofthe contract unless that portion is set forth in full in the policy. Any policyprovision in violation of this section is invalid.

 

26-15-116. Execution of policies.

 

 

(a) Any insurance policy shall be executed in the name of andon behalf of the insurer by its authorized officer, attorney-in-fact, employeeor other representative.

 

(b) A facsimile signature of any executing individual may beused instead of an original signature.

 

(c) No insurance contract which is otherwise valid shall berendered invalid by reason of the apparent execution thereof on behalf of theinsurer by the imprinted facsimile signature of an individual not authorized toexecute as of the date of the policy.

 

26-15-117. Underwriters' and combination policies.

 

 

(a) Two (2) or more authorized insurers may jointly issue, andare jointly and severally liable on, an underwriters' policy bearing theirnames. Any insurer may issue a policy in the name of an underwriters'department, and the policy shall plainly show the insurer's true name.

 

(b) Two (2) or more insurers, with the commissioner's approval,may issue a combination policy which shall contain provisions substantially asfollows:

 

(i) That the insurers executing the policy are severally liablefor the full amount of any loss or damage, according to the terms of thepolicy, or for specified percentages or amounts thereof, aggregating the fullamount of insurance under the policy; and

 

(ii) That service of process or of any notice or proof of lossrequired by the policy, upon any of the insurers executing the policy,constitutes service upon all the insurers.

 

(c) This section does not apply to cosurety obligations.

 

26-15-118. Validity and construction of noncomplying policies.

 

 

(a) Any policy delivered or issued for delivery to any personin this state in violation of this code, but otherwise binding on the insurer,is valid, but shall be construed as provided in this code.

 

(b) Any condition, omission or provision not in compliance withthis code and contained in any policy, rider or endorsement, otherwise valid,is not thereby invalid but shall be construed and applied in accordance withthe condition, omission or provision as would have applied if it had been infull compliance with this code.

 

26-15-119. Binders and other contracts for temporary insurance.

 

 

(a) Binders or other contracts for temporary insurance may bemade orally or in writing and include all the usual terms of the policy as towhich the binder is given together with applicable endorsements as aredesignated in the binder, except as superseded by the terms of the binder.

 

(b) No binder is valid beyond the issuance of the policy withrespect to which it is given, or beyond ninety (90) days from its effectivedate, whichever period is shorter.

 

(c) If the policy is not issued, a binder may be extended orrenewed beyond the ninety (90) days with the commissioner's written approval orin accordance with rules and regulations relative thereto the commissionerpromulgates.

 

(d) This section does not apply to life or disabilityinsurances.

 

26-15-120. Delivery of policy; duplicate policies.

 

Ifthe original policy is delivered or is required to be delivered to or fordeposit with any vendor, mortgagee or pledgee of any motor vehicle, and inwhich policy any interest of the vendee, mortgagor or pledgor in or withreference to the vehicle is insured, a duplicate of the policy setting forththe name and address of the insurer, insurance classification of vehicle, typeof coverage, limits of liability, premiums for the types of coverage, andduration of the policy, or memorandum thereof containing the same information,shall be delivered by the vendor, mortgagee or pledgee to each vendee,mortgagor or pledgor named in the policy or coming within the group of personsdesignated in the policy to be included. If the policy does not providecoverage of legal liability for injury to persons or damage to the property ofthird parties, a statement of that fact shall be printed, written or stamped conspicuouslyon the face of the duplicate policy or memorandum. This section does not applyto inland marine floater policies.

 

26-15-121. Renewal by certificate or endorsement.

 

 

(a) Except as provided in subsection (b) of this section, anyinsurance policy terminating by its terms at a specified expiration date, andnot otherwise renewable, may be renewed or extended:

 

(i) At the insurer's option;

 

(ii) Upon a currently authorized policy form and at the premiumrate then required for the policy;

 

(iii) For a specific additional period by certificates or bypolicy endorsement; and

 

(iv) Without requiring the issuance of a new policy.

 

(b) A private health benefit plan as defined in W.S.26-1-102(a)(xxxiii), shall be renewable with respect to all insureds at theoption of the insured except in the following cases:

 

(i) Nonpayment of the required premiums;

 

(ii) Fraud or misrepresentation by the insured; or

 

(iii) In the event the insurer elects not to renew an individualprivate health insurance plan, it may do so only if it elects not to renew allof its individual private health insurance benefit plans issued in this state. In the event the insurer elects not to renew a group private health benefitplan, it may do so only if it elects not to renew all of its group privatehealth benefit plans issued in this state. In either case, the insurer shall:

 

(A) Provide notice of the decision not to renew coverage to allaffected private health benefit plans and to all affected individually insuredpersons at least one hundred eighty (180) days prior to the nonrenewal of allhealth benefit plans by the insurer; and

 

(B) Provide notice of its decision under this paragraph to thecommissioner at least three (3) working days prior to providing the noticerequired under subparagraph (A) of this paragraph.

 

26-15-122. Assignment of policies.

 

Apolicy is assignable or not assignable as provided by its terms. Subject to itsterms relating to assignability, any life or disability policy, under the termsof which the beneficiary may be changed upon the sole request of the insured orowner, may be assigned either by pledge or transfer of title, by an assignmentexecuted by the insured or owner alone and delivered to the insurer, whether ornot the pledgee or assignee is the insurer. The assignment entitles the insurerto deal with the assignee as the owner or pledgee of the policy in accordancewith the terms of the assignment, until the insurer receives at its home officewritten notice of termination of the assignment or pledge, or written notice byor on behalf of some other person claiming some interest in the policy inconflict with the assignment.

 

26-15-123. Payment discharges insurer.

 

Ifthe proceeds of or payments under any life or disability insurance policy orannuity contract are payable in accordance with the terms of the policy orcontract, or the exercise of any right or privilege thereunder, and the insurermakes payment thereof in accordance with those terms or in accordance with anywritten assignment thereof, the person then designated as being entitledthereto is entitled to receive the proceeds or payments and to give fullacquittance therefor. The payments fully discharge the insurer from all claimsunder the policy or contract unless, before payment is made, the insurerreceives at its home office written notice by or on behalf of some other personthat the other person claims to be entitled to the payment or some interest inthe policy or contract.

 

26-15-124. Claim to be accepted or rejected; attorney's fee.

 

 

(a) Claims for benefits under a life, accident or healthinsurance policy shall be rejected or accepted and paid by the insurer or itsagent designated to receive the claims within forty-five (45) days afterreceipt of the proofs of loss and supporting evidence. Exceptions to the timeof forty-five (45) days shall be made for accident and health insurance claimsif there is any question as to the validity or the amount of the claim and thequestion is referred to the Wyoming state medical peer review committee foradjudication.

 

(b) Claims for benefits under a property or casualty insurancepolicy shall be rejected or accepted and paid by the insurer or its agentdesignated to receive those claims within forty-five (45) days after receipt ofthe claim and supporting bills.

 

(c) In any actions or proceedings commenced against anyinsurance company on any insurance policy or certificate of any type or kind ofinsurance, or in any case where an insurer is obligated by a liability insurancepolicy to defend any suit or claim or pay any judgment on behalf of a namedinsured, if it is determined that the company refuses to pay the full amount ofa loss covered by the policy and that the refusal is unreasonable or withoutcause, any court in which judgment is rendered for a claimant may also award areasonable sum as an attorney's fee and interest at ten percent (10%) per year.

 

26-15-125. Repealed by Laws 1993, ch. 1, 2.

 

26-15-126. Forms for proof of loss to be furnished.

 

Aninsurer, upon written request of any person claiming to have a loss under aninsurance contract issued by that insurer, shall furnish forms of proof of lossfor completion by the person. The insurer, because of the requirement tofurnish forms, does not have any responsibility for or with reference to thecompletion of the proof or the manner of any completion or attemptedcompletion.

 

26-15-127. Uniform health insurance claim forms.

 

Thecommissioner shall prescribe uniform health insurance claim forms and formatsfor governmental agencies and health care providers as defined by W.S.26-40-102(a)(i), which, after January 1, 1997, shall be used by all insurerstransacting health insurance in this state and by all governmental agencies andhealth care providers of this state that require health insurance claim formsor formats for their records.

 

26-15-128. Insurer's acts not constituting waiver of policy provisionsor defenses.

 

 

(a) None of the following acts by or on behalf of an insurerconstitutes a waiver of any provision of a policy, or of any right, or of anydefense of the insurer thereunder or otherwise:

 

(i) Acknowledgment of the receipt of notice of loss or claimunder the policy;

 

(ii) Furnishing forms for reporting a loss or claim, for givinginformation relative thereto, or for making proof of loss, or receiving oracknowledging receipt of the forms or proofs completed or uncompleted;

 

(iii) Investigating any loss or claim under any policy orengaging in negotiations looking toward a possible settlement of any such lossor claim.

 

26-15-129. Exemption of proceeds; life insurance.

 

(a) If a policy of insurance is executed by any person on hisown life or on another life, in favor of a person other than himself, or exceptin cases of transfer with intent to defraud creditors, if a policy of lifeinsurance is assigned or in any way made payable to that person, the lawfulbeneficiary or assignee thereof, other than the insured or the person executinginsurance or executors or administrators of the insured or the person executingthe insurance, are entitled to its proceeds, including death benefits, cashsurrender and loan values, premiums waived and dividends, whether used inreduction of premiums or otherwise, excepting only where the debtor, subsequentto issuance of the policy, has actually elected to receive the dividends incash, against the creditors and representatives of the insured and of theperson executing the policy, and are not liable to be applied by any legal orequitable process to pay any debt or liability of the insured individual or hisbeneficiary or of any other person having a right under the policy, whether ornot:

 

(i) The right to change the beneficiary is reserved orpermitted; and

 

(ii) The policy is made payable to the person whose life isinsured if the beneficiary or assignee predeceases that person, and theproceeds are exempt from all liability for any debt of the beneficiary existingat the time the policy is made available for his use.

 

(b) However, subject to the statute of limitations, the amountof any premiums paid for insurance with intent to defraud creditors, withinterest thereon, shall inure to their benefit from the policy proceeds; butthe insurer issuing the policy is discharged of all liability thereon bypayment of its proceeds in accordance with its terms, unless before payment theinsurer receives written notice at its home office, by or in behalf of acreditor of:

 

(i) A claim to recover for transfer made or premiums paid withintent to defraud creditors;

 

(ii) The amount claimed along with facts as will assist theinsurer to ascertain the particular policy.

 

(c) For the purposes of subsections (a) and (b) of thissection, a policy is payable to a person other than the insured if and to theextent that a facility-of-payment clause or similar clause in the policypermits the insurer to discharge its obligation after the death of theindividual insured by paying the death benefits to a person as permitted by theclause.

 

26-15-130. Exemption of proceeds; disability insurance.

 

Exceptas otherwise provided by the policy or contract, the proceeds of all contractsof disability insurance and of provisions specifying benefits because of theinsured's disability, which are supplemental to any life insurance or annuitycontracts executed, are exempt from all liability for any debt of the insuredand from any debt of the beneficiary existing at the time the proceeds are madeavailable for his use.

 

26-15-131. Exemption of proceeds; group insurance.

 

(a) A policy of group life insurance or group disabilityinsurance or the proceeds thereof, including death benefits, cash surrender andloan values, premiums waived and dividends, whether used in reduction ofpremiums or otherwise, excepting only where the debtor, subsequent to issuanceof the policy, has actually elected to receive the dividends in cash, payableto the individual insured or to the named beneficiary are not liable to beapplied by any legal or equitable process to pay any debt or liability of theinsured individual or his beneficiary or of any other person having a rightunder the policy. The proceeds, when not made payable to a named beneficiary,or to a third person pursuant to a facility-of-payment clause, do notconstitute a part of the insured individual's estate for the payment of hisdebts.

 

(b) This section does not apply to group insurance issuedpursuant to this code to a creditor covering his debtors, to the extent thatthe proceeds are applied to payment of the obligation for the purpose of whichthe insurance is issued.

 

26-15-132. Exemption of proceeds; annuity contracts; assignability ofrights.

 

 

(a) The benefits, rights, privileges and options which underany annuity contract issued are due or prospectively due the annuitant, are notsubject to execution nor is the annuitant compelled to exercise any suchrights, powers or options. Creditors are not allowed to interfere with orterminate the contract, except:

 

(i) As to amounts paid for or as premium on the annuity withintent to defraud creditors, with interest thereon, and of which the creditorgives the insurer written notice at its home office prior to the making of thepayment to the annuitant out of which the creditor seeks to recover, whichnotice shall specify:

 

(A) The amount claimed or facts to enable the ascertainment ofthe amount; and

 

(B) Facts to enable the insurer to ascertain the annuitycontract, the annuitant and the payment sought to be avoided on the ground offraud.

 

(ii) The total exemption of benefits presently due and payableto any annuitant periodically or at stated times under all annuity contractsunder which he is an annuitant shall not at any time exceed three hundred fiftydollars ($350.00) per month for the length of time represented by theinstallments, and any periodic payments in excess of three hundred fiftydollars ($350.00) per month are subject to garnishee execution to the sameextent as are wages and salaries;

 

(iii) If the total benefits presently due and payable to any annuitantunder any annuity contracts at any time exceed three hundred fifty dollars($350.00) per month, the court may order the annuitant to pay to a judgmentcreditor or apply on the judgment, in installments, that portion of the excessbenefits as to the court appear just and proper, after regard for thereasonable requirements of the judgment debtor and his family, if dependentupon him, as well as any payments required to be made by the annuitant to othercreditors under prior court order.

 

(b) If the contract provides, the benefits, rights, privilegesor options accruing under that contract to a beneficiary or assignee are nottransferable nor subject to commutation, and if the benefits are payableperiodically or at stated times, the same exemptions and exceptions containedin this section for the annuitant, apply to the beneficiary or assignee.

 

26-15-133. Retention of proceeds of policy by company.

 

 

(a) Any life insurer may hold the proceeds of any life orendowment insurance or annuity contract it issues:

 

(i) Upon the terms and restrictions as to revocation by theinsured and control by beneficiaries;

 

(ii) With the exemptions from legal process and the claims ofcreditors of beneficiaries, other than the insured; and

 

(iii) Upon any other terms and conditions, regardless of the timeand manner of payment of proceeds, agreed to in writing by the insurer and theinsured or beneficiary.

 

(b) The insurer is not required to segregate funds held undersubsection (a) of this section but may hold them as a part of its generalcorporate assets.

 

(c) The provisions of this section do not impair or affect anyrights of creditors under W.S. 26-15-129 or 26-15-132.

 

26-15-134. Venue of suits against insurers.

 

Suitupon causes of action arising within this state against an insurer over aninsurance contract shall be brought in the county where the cause of actionarose or in the county where the policyholder instituting the action resides.

 

26-15-135. Coverage of children.

 

(a) No insurance company, multi-employer trust or otherprovider of an individual, group or blanket health insurance product in thisstate shall:

 

(i) Refuse to accept and honor an otherwise valid claim for acovered service which is filed by either parent of a covered child, or by thedepartment of family services in the case of an assignment under W.S. 20-6-106,who submits valid copies of medical bills;

 

(ii) Refuse to provide medical insurance coverage of a childunder the health plan of the child's parent on the grounds that:

 

(A) The child was born out of wedlock;

 

(B) The child is not claimed as a dependent on the parent'sfederal tax return; or

 

(C) The child does not reside with the parent or in theinsurer's service area.

 

(iii) Refuse to provide medical insurance coverage for anotherwise insurable child under the policy if the child for whom the claim ismade is presumed to be the natural child of the insured under W.S. 14-2-504 or14-2-822.

 

(b) Where a child has health coverage through an insurer of anoncustodial parent or a parent sharing custody or temporary control of thechild the insurer shall:

 

(i) Provide such information to either parent sharing custodyor temporary control of the child as may be necessary for the child to obtainbenefits through that coverage;

 

(ii) Permit either parent sharing custody or temporary controlof the child, or the provider with either parent's approval, to submit claimsfor covered services without the approval of the other parent; and

 

(iii) Make payments on claims submitted in accordance withparagraph (ii) of this subsection directly to the parent who paid for theservices, the provider or the department of health as administrator of theWyoming Medical Assistance and Services Act.

 

(c) Where a parent is required by a court or administrativeorder to provide health coverage for a child and the parent is eligible forfamily health coverage, the insurer shall be required:

 

(i) To permit the parent to enroll under the family coverage, achild who is otherwise eligible for the coverage without regard to anyenrollment season restrictions;

 

(ii) If the parent is enrolled but fails to make application toobtain coverage for the child, to enroll the child under family coverage uponapplication of the child's other parent, the department of health inadministering the Wyoming Medical Assistance and Services Act, or thedepartment of family services in administering the child support enforcementprogram;

 

(iii) To complete and return the plan administrator response inconjunction with the national medical support notice to the department offamily services within forty (40) business days after the date of the notice;and

 

(iv) Not to disenroll or eliminate coverage of the child unlessthe insurer is provided satisfactory written evidence that:

 

(A) The court or administrative order is no longer in effect;or

 

(B) The child is or will be enrolled in comparable healthcoverage through another insurer which will take effect not later than theeffective date of disenrollment.

 

(d) An insurer may not impose requirements on a state agency,which has been assigned the rights of an individual eligible for medicalassistance under the Wyoming Medical Assistance and Services Act and coveredfor health benefits from the insurer, that are different from requirementsapplicable to an agent or assignee of any other individual so covered.

 

26-15-136. Assignment of insurance proceeds to doctor, hospital orstate agency; lien for state care; notice of lien.

 

 

(a) Whenever a contract by a third party agency provides forpayment to a beneficiary under the contract for expenses incurred by him formedical, surgical or hospital care, the beneficiary shall assign the benefitsof the contract to the Wyoming department of health or any doctor or hospital,or other practitioner rendering the care in an amount equal to the value of thecare rendered. Notification sent by registered or certified mail to the thirdparty agency, with a copy to the insured, shall provide authority for the paymentdirectly by the third party agency to the assignee. The state shall have alien, in an amount equal to the care rendered, on the proceeds of the contractsfor care rendered by any hospital, institution or other facility, writtennotice of which shall provide authority for payment directly by the third partyagency to the state.

 

(b) Whenever there is in existence a contract between aninsurer and an insured for payment to, or on behalf of, an applicant orrecipient of medical assistance under the contract for expenses incurred by theapplicant or recipient for medical services, including physician services,nursing services, pharmaceutical services, surgical care and hospital care, theassignment of the benefits of the contract by the applicant or recipient or alegally liable party shall, upon receipt of notice from the assignee, provideauthority for payment by the insurer directly to the assignee. If notice isprovided by the assignee to the insurer in accordance with the provisions ofW.S 42-4-204, the insurer shall be liable to the assignee for any amountpayable to the assignee under the contract.

 

ARTICLE 2 - INTERSTATE INSURANCE PRODUCT REGULATION

 

26-15-201. Interstate insurance product regulation compact.

 

The Interstate Insurance Product Regulation Compact ishereby enacted into law and entered into on behalf of this state with any andall other states legally joining therein in a form substantially as follows:

 

INTERSTATE INSURANCE PRODUCT REGULATIONCOMPACT

 

ARTICLEI

 

Purposes

 

(a) The purposes of this compact are, through means ofjoint and cooperative action among the compacting states:

 

(i) To promote and protect theinterest of consumers of individual and group annuity, life insurance,disability income and long-term care insurance products;

 

(ii) To develop uniform standardsfor insurance products covered under the compact;

 

(iii) To establish a centralclearinghouse to receive and provide prompt review of insurance productscovered under the compact and, in certain cases, advertisements relatedthereto, submitted by insurers authorized to do business in one or morecompacting states;

 

(iv) To give appropriateregulatory approval to those product filings and advertisements satisfying theapplicable uniform standard;

 

(v) To improve coordination of regulatory resources andexpertise between state insurance departments regarding the setting of uniformstandards and review of insurance products covered under the compact;

 

(vi) To create the interstate insurance product regulationcommission; and

 

(vii) To perform these and suchother related functions as may be consistent with the state regulation of thebusiness of insurance.

 

ARTICLE II

 

Definitions

 

(a) Notwithstanding W.S. 26-1-102, for purposes of this compact:

 

(i) "Advertisement" means any material designedto create public interest in a product, or induce the public to purchase,increase, modify, reinstate, borrow on, surrender, replace or retain a policy,as more specifically defined in the rules and operating procedures of thecommission;

 

(ii) "Bylaws" meansthose bylaws established by the commission for its governance, or for directingor controlling the commission's actions or conduct;

 

(iii) "Compacting state" means any state whichhas enacted this compact legislation and which has not withdrawn pursuant toarticle XIV, section 1, or been terminated pursuant to article XIV, section 2;

 

(iv) "Commission" means the "interstateinsurance product regulation commission" established by this compact;

 

(v) "Commissioner" means the chief insuranceregulatory official of a state including, but not limited to commissioner,superintendent, director or administrator;

 

(vi) "Domiciliary state" means the state inwhich an insurer is incorporated or organized or, in the case of an alieninsurer, its state of entry;

 

(vii) "Insurer" meansany entity licensed by a state to issue contracts of insurance for any of thelines of insurance covered by this compact;

 

(viii) "Member" meansthe person chosen by a compacting state as its representative to thecommission, or his or her designee;

 

(ix) "Noncompacting state" means any state whichis not at the time a compacting state;

 

(x) "Operatingprocedures" mean procedures promulgated by the commission implementing arule, uniform standard or a provision of this compact;

 

(xi) "Product" means theform of a policy or contract, including any application, endorsement or relatedform which is attached to and made a part of the policy or contract, and anyevidence of coverage or certificate, for an individual or group annuity, lifeinsurance, disability income or long-term care insurance product that aninsurer is authorized to issue;

 

(xii) "Rule" means astatement of general or particular applicability and future effect promulgatedby the commission, including a uniform standard developed pursuant to articleVII of this compact, designed to implement, interpret or prescribe law orpolicy or describing the organization, procedure or practice requirements ofthe commission, which shall have the force and effect of law in the compactingstates;

 

(xiii) "State" means any state, district or territory of the United Statesof America;

 

(xiv) "Third-party filer" means an entity that submits a product filing tothe commission on behalf of an insurer;

 

(xv) "Uniform standard" means a standard adopted by the commission for aproduct line, pursuant to article VII of this compact, and shall include all ofthe product requirements in aggregate, provided, that each uniform standardshall be construed, whether express or implied, to prohibit the use of anyinconsistent, misleading or ambiguous provisions in a product and the form ofthe product made available to the public shall not be unfair, inequitable oragainst public policy as determined by the commission.

 

ARTICLEIII

 

Establishmentof the commission and venue

 

(a) Thecompacting states hereby create and establish a joint public agency known asthe "interstate insurance product regulation commission." Pursuantto article IV, the commission will have the power to develop uniform standardsfor product lines, receive and provide prompt review of products filedtherewith and give approval to those product filings satisfying applicableuniform standards; provided, it is not intended for the commission to be theexclusive entity for receipt and review of insurance product filings. Nothingherein shall prohibit any insurer from filing its product in any state whereinthe insurer is licensed to conduct the business of insurance; and any suchfiling shall be subject to the laws of the state where filed.

 

(b) Thecommission is a body corporate and politic, and an instrumentality of thecompacting states.

 

(c) The commission is solely responsible for itsliabilities except as otherwise specifically provided in this compact.

 

(d) Venueis proper and judicial proceedings by or against the commission shall bebrought solely and exclusively in a court of competent jurisdiction where theprincipal office of the commission is located.

 

ARTICLEIV

 

Powersof the commission

 

(a) Thecommission shall have the following powers:

 

(i) Topromulgate rules, pursuant to article VII of this compact, which shall have theforce and effect of law and shall be binding in the compacting states to theextent and in the manner provided in this compact;

 

(ii) To exercise its rulemakingauthority and establish reasonable uniform standards for products covered underthe compact, and advertisement related thereto, which shall have the force andeffect of law and shall be binding in the compacting states, but only for thoseproducts filed with the commission, provided, that a compacting state shallhave the right to opt out of such uniform standard pursuant to article VII, tothe extent and in the manner provided in this compact, and, provided further,that any uniform standard established by the commission for long-term careinsurance products may provide the same or greater protections for consumersas, but shall not provide less than, those protections set forth in theNational Association of Insurance Commissioners' Long-Term Care Insurance ModelAct and Long-Term Care Insurance Model Regulation, respectively, adopted as of2001. The commission shall consider whether any subsequent amendments to theNational Association Of Insurance Commissioners' Long-Term Care Insurance ModelAct or Long-Term Care Insurance Model Regulation adopted by the nationalassociation of insurance commissioners require amending of the uniformstandards established by the commission for long-term care insurance products;

 

(iii) To receive and review in anexpeditious manner products filed with the commission, and rate filings fordisability income and long-term care insurance products, and give approval ofthose products and rate filings that satisfy the applicable uniform standard,where such approval shall have the force and effect of law and be binding onthe compacting states to the extent and in the manner provided in the compact;

 

(iv) To receive and review in anexpeditious manner advertisement relating to long-term care insurance productsfor which uniform standards have been adopted by the commission, and giveapproval to all advertisement that satisfies the applicable uniform standard. For any product covered under this compact, other than long-term care insuranceproducts, the commission shall have the authority to require an insurer tosubmit all or any part of its advertisement with respect to that product forreview or approval prior to use, if the commission determines that the natureof the product is such that an advertisement of the product could have thecapacity or tendency to mislead the public. The actions of commission asprovided in this section shall have the force and effect of law and shall bebinding in the compacting states to the extent and in the manner provided inthe compact;

 

(v) To exercise its rulemakingauthority and designate products and advertisement that may be subject to aself-certification process without the need for prior approval by thecommission;

 

(vi) To promulgate operatingprocedures, pursuant to article VII of this compact, which shall be binding inthe compacting states to the extent and in the manner provided in this compact;

 

(vii) To bringand prosecute legal proceedings or actions in its name as the commission;provided, that the standing of any state insurance department to sue or be suedunder applicable law shall not be affected;

 

(viii) To issue subpoenas requiring the attendance andtestimony of witnesses and the production of evidence;

 

(ix) To establishand maintain offices;

 

(x) To purchaseand maintain insurance and bonds;

 

(xi) To borrow, accept or contract for services ofpersonnel, including, but not limited to, employees of a compacting state;

 

(xii) To hire employees,professionals or specialists, and elect or appoint officers, and to fix theircompensation, define their duties and give them appropriate authority to carryout the purposes of the compact, and determine their qualifications; and toestablish the commission's personnel policies and programs relating to, amongother things, conflicts of interest, rates of compensation and qualificationsof personnel;

 

(xiii) To accept any and allappropriate donations and grants of money, equipment, supplies, materials andservices, and to receive, utilize and dispose of the same; provided that at alltimes the commission


State Codes and Statutes

State Codes and Statutes

Statutes > Wyoming > Title26 > Chapter15

CHAPTER 15 - THE INSURANCE CONTRACT

 

ARTICLE 1 - IN GENERAL

 

26-15-101. Scope of chapter.

 

 

(a) This chapter applies to all insurance contracts and annuitycontracts except:

 

(i) Reinsurance;

 

(ii) Policies or contracts not issued for delivery in this statenor delivered in this state;

 

(iii) Wet marine and transportation insurance.

 

26-15-102. Life insurance upon individual or person in whom he hasinsurable interest; "insurable interest" defined.

 

 

(a) Any individual of competent legal capacity may procure oreffect an insurance contract upon his own life or body for the benefit of anyperson. Except as provided in W.S. 26-15-103, no person shall procure or causeto be procured any insurance contract upon the life or body of anotherindividual unless the benefits under the contract are payable to the individualinsured or his personal representatives, or to a person having, at the timewhen the contract is made, an insurable interest in the individual insured.

 

(b) If the beneficiary, assignee or other payee under anycontract made in violation of this section receives from the insurer anybenefits thereunder accruing upon the death, disablement or injury of theindividual insured, the individual insured or his executor or administrator, asthe case may be, may maintain an action to recover the benefits from the personreceiving them.

 

(c) "Insurable interest" as to personal insurancemeans that any individual has an insurable interest in the life, body andhealth of himself, and of other persons as follows:

 

(i) In the case of individuals related closely by blood or bylaw, a substantial interest engendered by love and affection;

 

(ii) In the case of other persons, a lawful and substantialeconomic interest in having the life, health or bodily safety of the individualinsured continue, as distinguished from an interest arising only by, orenhanced in value by, the death, disablement or injury of the individualinsured; and

 

(iii) An individual party to a contract or option for thepurchase or sale of an interest in a business partnership or firm, or of sharesof stock of a closed corporation or of an interest in those shares, has aninsurable interest in the life of each individual party to the contract and forthe purposes of the contract only, in addition to any insurable interest whichotherwise exists as to that individual's life.

 

(d) An insurer may rely upon all statements, declarations andrepresentations made by an applicant for insurance relative to the applicant'sinsurable interest in the insured. No insurer incurs legal liability, except asset forth in the policy, by virtue of any untrue statements, declarations orrepresentations relied upon in good faith.

 

26-15-103. Life insurance for benefit of charitable institutions.

 

 

(a) Contracts of life insurance may be made and entered into inwhich the person paying the consideration for the insurance has no insurableinterest in the life of the person insured, if charitable, benevolent,educational or religious institutions are designated irrevocably as abeneficiary but not necessarily the primary beneficiary thereof.

 

(b) In making a contract as specified in subsection (a) of thissection, the person paying the premium shall make and sign the applicationtherefor as owner and shall designate a charitable, benevolent, educational orreligious institution irrevocably as the beneficiary or one (1) of thebeneficiaries of the policy. The application also shall be signed by the personwhose life is to be insured.

 

(c) The contract is valid and binding among all of the partiesthereto, notwithstanding that the owner has no insurable interest in the lifeof the person insured.

 

26-15-104. Insurable interest in property; "insurableinterest" defined.

 

 

(a) No contract of insurance of property or of any interest inproperty or arising from property is enforceable as to the insurance except forthe benefit of persons having an insurable interest in the things insured atthe time of the loss.

 

(b) The measure of an insurable interest in property is theextent to which the insured might be directly or indirectly damnified by lossor impairment thereof.

 

(c) "Insurable interest" as used in this sectionmeans any actual, lawful and substantial economic interest in the safety orpreservation of the subject of the insurance free from loss, destruction orpecuniary damage or impairment.

 

26-15-105. Purchase of life insurance by or for minors or any person ofcompetent legal capacity.

 

 

(a) Any person of competent legal capacity may contract forinsurance.

 

(b) Any minor not less than fifteen (15) years of age,notwithstanding his minority, may contract for or own annuities, or insurance,or affirm by novation or otherwise preexisting contracts for annuities orinsurance upon his own life, body, health, property, liabilities or otherinterests, or on the person of another in whom the minor has an insurableinterest. The minor, notwithstanding his minority, may exercise all rights andpowers with respect to or under any contract for annuity or for insurance uponhis own life, body or health, or any contract the minor effects upon his ownproperty, liabilities or other interests, or any contract the minor owns oreffects on the person of another, as might be exercised by a person of fulllegal age, and may at any time surrender his interest in any such contracts andgive valid discharge for any benefit accruing or money payable thereunder. Theminor, by reason of his minority, is not entitled to rescind, avoid orrepudiate the contract, nor to rescind, avoid or repudiate any exercise of aright or privilege thereunder, except that such a minor not otherwiseemancipated is not bound by any unperformed agreement to pay, by promissorynote or otherwise, any premium on any such annuity or insurance contract.

 

(c) Any annuity contract or policy of life disability insuranceprocured by or for a minor under subsection (b) of this section, shall be madepayable either to the minor or his estate or to a person having an insurableinterest in the minor's life.

 

26-15-106. Application to be made by individual insured; exceptions.

 

 

(a) No life or disability insurance contract upon anindividual, except a contract of group life insurance or of group or blanketdisability insurance, shall be made or carried out unless at the time of themaking of the contract the individual insured, being of competent legalcapacity to contract, applies therefor or has consented thereto in writing,except:

 

(i) A spouse may carry out the insurance upon the other spouse;

 

(ii) Any person having an insurable interest in the life of aminor, or any person upon whom a minor is dependent for support andmaintenance, may carry out insurance upon the life of or pertaining to theminor;

 

(iii) Family policies may be issued insuring any two (2) or moremembers of a family on an application signed by either parent, a stepparent orby a husband or wife.

 

26-15-107. Alteration of application prohibited; exceptions.

 

Noalteration of any written application for any life or disability insurancepolicy shall be made by any person other than the applicant without his writtenconsent, except that the insurer may make insertions for administrativepurposes only in a manner as to indicate clearly that the insertions are not tobe ascribed to the applicant.

 

26-15-108. Application as evidence.

 

 

(a) No application for the issuance of any life or disabilityinsurance policy or annuity contract is admissible in evidence in any actionrelative to the policy or contract, unless a true copy of the application isattached to or otherwise made a part of the policy or contract when issued.This provision does not apply to industrial life insurance policies.

 

(b) If any life or disability insurance policy delivered inthis state is reinstated or renewed, and the insured or the policy beneficiaryor assignee makes written request to the insurer for a copy of thereinstatement or renewal application, if any, the insurer, within thirty (30)days after receipt of the request at its home office, shall deliver or mail tothe person making the request a copy of the application reproduced by anylegible means. If the copy is not delivered or mailed after having beenrequested, the insurer is precluded from introducing the application in evidencein any action or proceeding based upon or involving the policy or itsreinstatement or renewal. In the case of a request from a beneficiary, the timewithin which the insurer is required to furnish a copy of the application doesnot begin to run until after receipt of evidence satisfactory to the insurer ofthe beneficiary's vested interest in the policy or contract.

 

(c) As to insurance other than life or disability insurance, noapplication for insurance signed by or on behalf of the insured is admissiblein evidence in any action between the insured and the insurer arising out ofthe policy so applied for, if the insurer fails, at expiration of thirty (30)days after receipt of written demand therefor by or on behalf of the insured,to furnish to the insured a copy of the application reproduced by any legiblemeans.

 

26-15-109. Statements in applications as representations and not aswarranties; misrepresentations.

 

 

(a) Any statements and descriptions in any application for aninsurance policy or annuity contract, by or in behalf of the insured orannuitant, are representations and not warranties. Misrepresentations,omissions, concealment of facts and incorrect statements do not prevent arecovery under the policy or contract unless either:

 

(i) Fraudulent; or

 

(ii) Material either to the acceptance of the risk, or to thehazard the insurer assumes; or

 

(iii) The insurer in good faith, if it knew the true facts asrequired by the application for the policy or contract or otherwise, would nothave:

 

(A) Issued the policy or contract;

 

(B) Issued it at the same premium rate;

 

(C) Issued a policy or contract in as large an amount; or

 

(D) Provided coverage with respect to the hazard resulting inthe loss.

 

26-15-110. Filing and approval of application forms.

 

(a) No basic insurance policy or annuity contract form, orapplication form if written application is required and is to be made a part ofthe policy or contract, or printed rider or endorsement form or form of renewalcertificate, shall be delivered or issued for delivery in this state unless theform is filed with and approved by the commissioner or is approved as providedin W.S. 26-15-201. This provision does not apply to surety bonds, or tospecially rated inland marine risks, nor to policies, riders, endorsements orforms of unique character designed for and used with relation to insurance upona particular subject, or which relate to the manner of distribution of benefitsor to the reservation of rights and benefits under life or disability insurancepolicies and are used at the request of the individual policyholder, contractholder or certificate holder. As to forms for use in property, marine, otherthan wet marine and transportation insurance, casualty and surety insurance coverages,the filing required by this subsection may be made by advisory and ratingorganizations on behalf of their members and subscribers. This provision doesnot prohibit any member or subscriber from filing the forms on its own behalf.

 

(b) Any filing shall be made not less than forty-five (45) daysin advance of any delivery. At the expiration of forty-five (45) days the formfiled is approved unless affirmatively approved or disapproved by thecommissioner's order. Approval of any form by the commissioner constitutes awaiver of any unexpired portion of the waiting period. The commissioner mayextend by not more than an additional forty-five (45) days the period withinwhich he may affirmatively approve or disapprove any form, by giving notice tothe insurer of the extension before expiration of the initial forty-five (45)day period. At the expiration of any extended period, and in the absence ofprior affirmative approval or disapproval, any form is deemed approved. Thecommissioner, at any time, after notice and for cause shown, may withdraw anyapproval.

 

(c) Any order of the commissioner disapproving a form orwithdrawing a previous approval shall state the grounds and the particulars forthe withdrawal in such detail as to reasonably inform the insurer. Thewithdrawal of a previously approved form is effective at the expiration of theperiod the commissioner prescribes in the notice, but not less than thirty (30)days from the date of the notice.

 

(d) The commissioner, by order, may exempt from therequirements of this section for so long as he deems proper any insurancedocument or form or type thereof as specified in the order, to which, in hisopinion:

 

(i) This section may not practicably be applied;

 

(ii) The filing and approval of which are not desirable ornecessary for the public's protection; or

 

(iii) The document or form or type thereof has been approvedunder the provisions of the Interstate Insurance Product Regulation Compact asprovided in W.S. 26-15-201.

 

(e) Appeals from the commissioner's orders disapproving a formor withdrawing a previous approval may be taken as provided in W.S. 26-2-125through 26-2-129.

 

26-15-111. Filing and approval of application forms; grounds fordisapproval.

 

 

(a) The commissioner, within forty-five (45) days after filingof any insurance policy, shall disapprove any form filed under W.S. 26-15-110,or withdraw any previous approval thereof, only if:

 

(i) The form:

 

(A) Is in any respect in violation of or does not comply withthis code;

 

(B) Contains or incorporates by reference, if the incorporationis otherwise permissible, any inconsistent, ambiguous or misleading clauses, orexceptions and conditions which deceptively affect the risk purported to beassumed in the general coverage of the contract;

 

(C) Has any title, heading, or other indication of itsprovisions which is misleading; or

 

(D) Is printed or otherwise reproduced in such manner as torender any provision of the form substantially illegible; or

 

(ii) He finds that:

 

(A) The benefits provided in the policy are unreasonable inrelation to the premiums charged; or

 

(B) The rates or classification are excessive, inadequate orunfairly discriminatory. This paragraph does not apply to any policy form forinsurance except those lines of insurance deemed noncompetitive under W.S.26-14-101 through 26-14-118 [ 26-14-101 through26-14-119].

 

(b) If the commissioner disapproves the insurance policy, theinsurer may request a hearing pursuant to the Wyoming Administrative ProcedureAct.

 

26-15-112. Standard and uniform provisions of policies.

 

 

(a) Insurance contracts shall contain any standard or uniformprovisions required by the applicable provisions of this code pertaining tocontracts of particular kinds of insurance. The commissioner may waive therequired use of a particular provision in a particular insurance policy formif:

 

(i) He finds the provision unnecessary for the insured'sprotection and inconsistent with the policy's purposes; and

 

(ii) He otherwise approves the policy.

 

(b) No policy shall contain any provision inconsistent with orcontradictory to any standard or uniform provision used or required to be used,but the commissioner may approve any substitute provision which, in hisopinion, is not less favorable in any particular to the insured or beneficiarythan the provisions otherwise required.

 

(c) Instead of the provisions required by this code forcontracts for particular kinds of insurance, substantially similar provisionsrequired by the law of the domicile of a foreign or alien insurer may be usedif the commissioner approves.

 

(d) A policy issued by a domestic insurer for delivery inanother jurisdiction may contain any provision required or permitted by thelaws of that jurisdiction.

 

26-15-113. Contents of policies generally.

 

 

(a) Any policy shall specify:

 

(i) The names of the parties to the contract;

 

(ii) The subject of the insurance;

 

(iii) The risks insured against;

 

(iv) The time when the insurance thereunder takes effect and theperiod during which the insurance is to continue;

 

(v) The premium;

 

(vi) The conditions pertaining to the insurance;

 

(vii) Benefits payable, if a life or disability insurancecontract.

 

(b) The commissioner, by rule or regulation, may require a lifeinsurer to show in life insurance policies, by reasonable itemization thereof,the amount of premium charged for optional, unique or particular materialfeatures or benefits included in or with the policy. The commissioner may alsospecify what portion of the charge by the insurer for or in connection withtitle insurance shall be set forth in the policy.

 

(c) If under the policy the exact amount of premium isdeterminable only at stated intervals or upon termination of the contract, a statementof the basis and rates upon which the premium is to be determined and paidshall be included.

 

(d) Subsections (a) through (c) of this section do not apply tosurety contracts or to group insurance policies.

 

26-15-114. Additional policy contents.

 

 

(a) A policy may contain additional provisions not inconsistentwith this code and which are:

 

(i) Required to be inserted by the laws of the insurer'sdomicile;

 

(ii) Necessary, because of the manner in which the insurer isconstituted or operated, in order to state the rights and obligations of theparties to the contract; or

 

(iii) Desired by the insurer and neither prohibited by law nor inconflict with any provisions required to be included therein.

 

26-15-115. Adoption of charter and bylaws by reference prohibited.

 

Nopolicy shall contain any provision purporting to make any portion of thecharter, bylaws or other constituent document of the insurer, other than thesubscriber's agreement or power of attorney of a reciprocal insurer, a part ofthe contract unless that portion is set forth in full in the policy. Any policyprovision in violation of this section is invalid.

 

26-15-116. Execution of policies.

 

 

(a) Any insurance policy shall be executed in the name of andon behalf of the insurer by its authorized officer, attorney-in-fact, employeeor other representative.

 

(b) A facsimile signature of any executing individual may beused instead of an original signature.

 

(c) No insurance contract which is otherwise valid shall berendered invalid by reason of the apparent execution thereof on behalf of theinsurer by the imprinted facsimile signature of an individual not authorized toexecute as of the date of the policy.

 

26-15-117. Underwriters' and combination policies.

 

 

(a) Two (2) or more authorized insurers may jointly issue, andare jointly and severally liable on, an underwriters' policy bearing theirnames. Any insurer may issue a policy in the name of an underwriters'department, and the policy shall plainly show the insurer's true name.

 

(b) Two (2) or more insurers, with the commissioner's approval,may issue a combination policy which shall contain provisions substantially asfollows:

 

(i) That the insurers executing the policy are severally liablefor the full amount of any loss or damage, according to the terms of thepolicy, or for specified percentages or amounts thereof, aggregating the fullamount of insurance under the policy; and

 

(ii) That service of process or of any notice or proof of lossrequired by the policy, upon any of the insurers executing the policy,constitutes service upon all the insurers.

 

(c) This section does not apply to cosurety obligations.

 

26-15-118. Validity and construction of noncomplying policies.

 

 

(a) Any policy delivered or issued for delivery to any personin this state in violation of this code, but otherwise binding on the insurer,is valid, but shall be construed as provided in this code.

 

(b) Any condition, omission or provision not in compliance withthis code and contained in any policy, rider or endorsement, otherwise valid,is not thereby invalid but shall be construed and applied in accordance withthe condition, omission or provision as would have applied if it had been infull compliance with this code.

 

26-15-119. Binders and other contracts for temporary insurance.

 

 

(a) Binders or other contracts for temporary insurance may bemade orally or in writing and include all the usual terms of the policy as towhich the binder is given together with applicable endorsements as aredesignated in the binder, except as superseded by the terms of the binder.

 

(b) No binder is valid beyond the issuance of the policy withrespect to which it is given, or beyond ninety (90) days from its effectivedate, whichever period is shorter.

 

(c) If the policy is not issued, a binder may be extended orrenewed beyond the ninety (90) days with the commissioner's written approval orin accordance with rules and regulations relative thereto the commissionerpromulgates.

 

(d) This section does not apply to life or disabilityinsurances.

 

26-15-120. Delivery of policy; duplicate policies.

 

Ifthe original policy is delivered or is required to be delivered to or fordeposit with any vendor, mortgagee or pledgee of any motor vehicle, and inwhich policy any interest of the vendee, mortgagor or pledgor in or withreference to the vehicle is insured, a duplicate of the policy setting forththe name and address of the insurer, insurance classification of vehicle, typeof coverage, limits of liability, premiums for the types of coverage, andduration of the policy, or memorandum thereof containing the same information,shall be delivered by the vendor, mortgagee or pledgee to each vendee,mortgagor or pledgor named in the policy or coming within the group of personsdesignated in the policy to be included. If the policy does not providecoverage of legal liability for injury to persons or damage to the property ofthird parties, a statement of that fact shall be printed, written or stamped conspicuouslyon the face of the duplicate policy or memorandum. This section does not applyto inland marine floater policies.

 

26-15-121. Renewal by certificate or endorsement.

 

 

(a) Except as provided in subsection (b) of this section, anyinsurance policy terminating by its terms at a specified expiration date, andnot otherwise renewable, may be renewed or extended:

 

(i) At the insurer's option;

 

(ii) Upon a currently authorized policy form and at the premiumrate then required for the policy;

 

(iii) For a specific additional period by certificates or bypolicy endorsement; and

 

(iv) Without requiring the issuance of a new policy.

 

(b) A private health benefit plan as defined in W.S.26-1-102(a)(xxxiii), shall be renewable with respect to all insureds at theoption of the insured except in the following cases:

 

(i) Nonpayment of the required premiums;

 

(ii) Fraud or misrepresentation by the insured; or

 

(iii) In the event the insurer elects not to renew an individualprivate health insurance plan, it may do so only if it elects not to renew allof its individual private health insurance benefit plans issued in this state. In the event the insurer elects not to renew a group private health benefitplan, it may do so only if it elects not to renew all of its group privatehealth benefit plans issued in this state. In either case, the insurer shall:

 

(A) Provide notice of the decision not to renew coverage to allaffected private health benefit plans and to all affected individually insuredpersons at least one hundred eighty (180) days prior to the nonrenewal of allhealth benefit plans by the insurer; and

 

(B) Provide notice of its decision under this paragraph to thecommissioner at least three (3) working days prior to providing the noticerequired under subparagraph (A) of this paragraph.

 

26-15-122. Assignment of policies.

 

Apolicy is assignable or not assignable as provided by its terms. Subject to itsterms relating to assignability, any life or disability policy, under the termsof which the beneficiary may be changed upon the sole request of the insured orowner, may be assigned either by pledge or transfer of title, by an assignmentexecuted by the insured or owner alone and delivered to the insurer, whether ornot the pledgee or assignee is the insurer. The assignment entitles the insurerto deal with the assignee as the owner or pledgee of the policy in accordancewith the terms of the assignment, until the insurer receives at its home officewritten notice of termination of the assignment or pledge, or written notice byor on behalf of some other person claiming some interest in the policy inconflict with the assignment.

 

26-15-123. Payment discharges insurer.

 

Ifthe proceeds of or payments under any life or disability insurance policy orannuity contract are payable in accordance with the terms of the policy orcontract, or the exercise of any right or privilege thereunder, and the insurermakes payment thereof in accordance with those terms or in accordance with anywritten assignment thereof, the person then designated as being entitledthereto is entitled to receive the proceeds or payments and to give fullacquittance therefor. The payments fully discharge the insurer from all claimsunder the policy or contract unless, before payment is made, the insurerreceives at its home office written notice by or on behalf of some other personthat the other person claims to be entitled to the payment or some interest inthe policy or contract.

 

26-15-124. Claim to be accepted or rejected; attorney's fee.

 

 

(a) Claims for benefits under a life, accident or healthinsurance policy shall be rejected or accepted and paid by the insurer or itsagent designated to receive the claims within forty-five (45) days afterreceipt of the proofs of loss and supporting evidence. Exceptions to the timeof forty-five (45) days shall be made for accident and health insurance claimsif there is any question as to the validity or the amount of the claim and thequestion is referred to the Wyoming state medical peer review committee foradjudication.

 

(b) Claims for benefits under a property or casualty insurancepolicy shall be rejected or accepted and paid by the insurer or its agentdesignated to receive those claims within forty-five (45) days after receipt ofthe claim and supporting bills.

 

(c) In any actions or proceedings commenced against anyinsurance company on any insurance policy or certificate of any type or kind ofinsurance, or in any case where an insurer is obligated by a liability insurancepolicy to defend any suit or claim or pay any judgment on behalf of a namedinsured, if it is determined that the company refuses to pay the full amount ofa loss covered by the policy and that the refusal is unreasonable or withoutcause, any court in which judgment is rendered for a claimant may also award areasonable sum as an attorney's fee and interest at ten percent (10%) per year.

 

26-15-125. Repealed by Laws 1993, ch. 1, 2.

 

26-15-126. Forms for proof of loss to be furnished.

 

Aninsurer, upon written request of any person claiming to have a loss under aninsurance contract issued by that insurer, shall furnish forms of proof of lossfor completion by the person. The insurer, because of the requirement tofurnish forms, does not have any responsibility for or with reference to thecompletion of the proof or the manner of any completion or attemptedcompletion.

 

26-15-127. Uniform health insurance claim forms.

 

Thecommissioner shall prescribe uniform health insurance claim forms and formatsfor governmental agencies and health care providers as defined by W.S.26-40-102(a)(i), which, after January 1, 1997, shall be used by all insurerstransacting health insurance in this state and by all governmental agencies andhealth care providers of this state that require health insurance claim formsor formats for their records.

 

26-15-128. Insurer's acts not constituting waiver of policy provisionsor defenses.

 

 

(a) None of the following acts by or on behalf of an insurerconstitutes a waiver of any provision of a policy, or of any right, or of anydefense of the insurer thereunder or otherwise:

 

(i) Acknowledgment of the receipt of notice of loss or claimunder the policy;

 

(ii) Furnishing forms for reporting a loss or claim, for givinginformation relative thereto, or for making proof of loss, or receiving oracknowledging receipt of the forms or proofs completed or uncompleted;

 

(iii) Investigating any loss or claim under any policy orengaging in negotiations looking toward a possible settlement of any such lossor claim.

 

26-15-129. Exemption of proceeds; life insurance.

 

(a) If a policy of insurance is executed by any person on hisown life or on another life, in favor of a person other than himself, or exceptin cases of transfer with intent to defraud creditors, if a policy of lifeinsurance is assigned or in any way made payable to that person, the lawfulbeneficiary or assignee thereof, other than the insured or the person executinginsurance or executors or administrators of the insured or the person executingthe insurance, are entitled to its proceeds, including death benefits, cashsurrender and loan values, premiums waived and dividends, whether used inreduction of premiums or otherwise, excepting only where the debtor, subsequentto issuance of the policy, has actually elected to receive the dividends incash, against the creditors and representatives of the insured and of theperson executing the policy, and are not liable to be applied by any legal orequitable process to pay any debt or liability of the insured individual or hisbeneficiary or of any other person having a right under the policy, whether ornot:

 

(i) The right to change the beneficiary is reserved orpermitted; and

 

(ii) The policy is made payable to the person whose life isinsured if the beneficiary or assignee predeceases that person, and theproceeds are exempt from all liability for any debt of the beneficiary existingat the time the policy is made available for his use.

 

(b) However, subject to the statute of limitations, the amountof any premiums paid for insurance with intent to defraud creditors, withinterest thereon, shall inure to their benefit from the policy proceeds; butthe insurer issuing the policy is discharged of all liability thereon bypayment of its proceeds in accordance with its terms, unless before payment theinsurer receives written notice at its home office, by or in behalf of acreditor of:

 

(i) A claim to recover for transfer made or premiums paid withintent to defraud creditors;

 

(ii) The amount claimed along with facts as will assist theinsurer to ascertain the particular policy.

 

(c) For the purposes of subsections (a) and (b) of thissection, a policy is payable to a person other than the insured if and to theextent that a facility-of-payment clause or similar clause in the policypermits the insurer to discharge its obligation after the death of theindividual insured by paying the death benefits to a person as permitted by theclause.

 

26-15-130. Exemption of proceeds; disability insurance.

 

Exceptas otherwise provided by the policy or contract, the proceeds of all contractsof disability insurance and of provisions specifying benefits because of theinsured's disability, which are supplemental to any life insurance or annuitycontracts executed, are exempt from all liability for any debt of the insuredand from any debt of the beneficiary existing at the time the proceeds are madeavailable for his use.

 

26-15-131. Exemption of proceeds; group insurance.

 

(a) A policy of group life insurance or group disabilityinsurance or the proceeds thereof, including death benefits, cash surrender andloan values, premiums waived and dividends, whether used in reduction ofpremiums or otherwise, excepting only where the debtor, subsequent to issuanceof the policy, has actually elected to receive the dividends in cash, payableto the individual insured or to the named beneficiary are not liable to beapplied by any legal or equitable process to pay any debt or liability of theinsured individual or his beneficiary or of any other person having a rightunder the policy. The proceeds, when not made payable to a named beneficiary,or to a third person pursuant to a facility-of-payment clause, do notconstitute a part of the insured individual's estate for the payment of hisdebts.

 

(b) This section does not apply to group insurance issuedpursuant to this code to a creditor covering his debtors, to the extent thatthe proceeds are applied to payment of the obligation for the purpose of whichthe insurance is issued.

 

26-15-132. Exemption of proceeds; annuity contracts; assignability ofrights.

 

 

(a) The benefits, rights, privileges and options which underany annuity contract issued are due or prospectively due the annuitant, are notsubject to execution nor is the annuitant compelled to exercise any suchrights, powers or options. Creditors are not allowed to interfere with orterminate the contract, except:

 

(i) As to amounts paid for or as premium on the annuity withintent to defraud creditors, with interest thereon, and of which the creditorgives the insurer written notice at its home office prior to the making of thepayment to the annuitant out of which the creditor seeks to recover, whichnotice shall specify:

 

(A) The amount claimed or facts to enable the ascertainment ofthe amount; and

 

(B) Facts to enable the insurer to ascertain the annuitycontract, the annuitant and the payment sought to be avoided on the ground offraud.

 

(ii) The total exemption of benefits presently due and payableto any annuitant periodically or at stated times under all annuity contractsunder which he is an annuitant shall not at any time exceed three hundred fiftydollars ($350.00) per month for the length of time represented by theinstallments, and any periodic payments in excess of three hundred fiftydollars ($350.00) per month are subject to garnishee execution to the sameextent as are wages and salaries;

 

(iii) If the total benefits presently due and payable to any annuitantunder any annuity contracts at any time exceed three hundred fifty dollars($350.00) per month, the court may order the annuitant to pay to a judgmentcreditor or apply on the judgment, in installments, that portion of the excessbenefits as to the court appear just and proper, after regard for thereasonable requirements of the judgment debtor and his family, if dependentupon him, as well as any payments required to be made by the annuitant to othercreditors under prior court order.

 

(b) If the contract provides, the benefits, rights, privilegesor options accruing under that contract to a beneficiary or assignee are nottransferable nor subject to commutation, and if the benefits are payableperiodically or at stated times, the same exemptions and exceptions containedin this section for the annuitant, apply to the beneficiary or assignee.

 

26-15-133. Retention of proceeds of policy by company.

 

 

(a) Any life insurer may hold the proceeds of any life orendowment insurance or annuity contract it issues:

 

(i) Upon the terms and restrictions as to revocation by theinsured and control by beneficiaries;

 

(ii) With the exemptions from legal process and the claims ofcreditors of beneficiaries, other than the insured; and

 

(iii) Upon any other terms and conditions, regardless of the timeand manner of payment of proceeds, agreed to in writing by the insurer and theinsured or beneficiary.

 

(b) The insurer is not required to segregate funds held undersubsection (a) of this section but may hold them as a part of its generalcorporate assets.

 

(c) The provisions of this section do not impair or affect anyrights of creditors under W.S. 26-15-129 or 26-15-132.

 

26-15-134. Venue of suits against insurers.

 

Suitupon causes of action arising within this state against an insurer over aninsurance contract shall be brought in the county where the cause of actionarose or in the county where the policyholder instituting the action resides.

 

26-15-135. Coverage of children.

 

(a) No insurance company, multi-employer trust or otherprovider of an individual, group or blanket health insurance product in thisstate shall:

 

(i) Refuse to accept and honor an otherwise valid claim for acovered service which is filed by either parent of a covered child, or by thedepartment of family services in the case of an assignment under W.S. 20-6-106,who submits valid copies of medical bills;

 

(ii) Refuse to provide medical insurance coverage of a childunder the health plan of the child's parent on the grounds that:

 

(A) The child was born out of wedlock;

 

(B) The child is not claimed as a dependent on the parent'sfederal tax return; or

 

(C) The child does not reside with the parent or in theinsurer's service area.

 

(iii) Refuse to provide medical insurance coverage for anotherwise insurable child under the policy if the child for whom the claim ismade is presumed to be the natural child of the insured under W.S. 14-2-504 or14-2-822.

 

(b) Where a child has health coverage through an insurer of anoncustodial parent or a parent sharing custody or temporary control of thechild the insurer shall:

 

(i) Provide such information to either parent sharing custodyor temporary control of the child as may be necessary for the child to obtainbenefits through that coverage;

 

(ii) Permit either parent sharing custody or temporary controlof the child, or the provider with either parent's approval, to submit claimsfor covered services without the approval of the other parent; and

 

(iii) Make payments on claims submitted in accordance withparagraph (ii) of this subsection directly to the parent who paid for theservices, the provider or the department of health as administrator of theWyoming Medical Assistance and Services Act.

 

(c) Where a parent is required by a court or administrativeorder to provide health coverage for a child and the parent is eligible forfamily health coverage, the insurer shall be required:

 

(i) To permit the parent to enroll under the family coverage, achild who is otherwise eligible for the coverage without regard to anyenrollment season restrictions;

 

(ii) If the parent is enrolled but fails to make application toobtain coverage for the child, to enroll the child under family coverage uponapplication of the child's other parent, the department of health inadministering the Wyoming Medical Assistance and Services Act, or thedepartment of family services in administering the child support enforcementprogram;

 

(iii) To complete and return the plan administrator response inconjunction with the national medical support notice to the department offamily services within forty (40) business days after the date of the notice;and

 

(iv) Not to disenroll or eliminate coverage of the child unlessthe insurer is provided satisfactory written evidence that:

 

(A) The court or administrative order is no longer in effect;or

 

(B) The child is or will be enrolled in comparable healthcoverage through another insurer which will take effect not later than theeffective date of disenrollment.

 

(d) An insurer may not impose requirements on a state agency,which has been assigned the rights of an individual eligible for medicalassistance under the Wyoming Medical Assistance and Services Act and coveredfor health benefits from the insurer, that are different from requirementsapplicable to an agent or assignee of any other individual so covered.

 

26-15-136. Assignment of insurance proceeds to doctor, hospital orstate agency; lien for state care; notice of lien.

 

 

(a) Whenever a contract by a third party agency provides forpayment to a beneficiary under the contract for expenses incurred by him formedical, surgical or hospital care, the beneficiary shall assign the benefitsof the contract to the Wyoming department of health or any doctor or hospital,or other practitioner rendering the care in an amount equal to the value of thecare rendered. Notification sent by registered or certified mail to the thirdparty agency, with a copy to the insured, shall provide authority for the paymentdirectly by the third party agency to the assignee. The state shall have alien, in an amount equal to the care rendered, on the proceeds of the contractsfor care rendered by any hospital, institution or other facility, writtennotice of which shall provide authority for payment directly by the third partyagency to the state.

 

(b) Whenever there is in existence a contract between aninsurer and an insured for payment to, or on behalf of, an applicant orrecipient of medical assistance under the contract for expenses incurred by theapplicant or recipient for medical services, including physician services,nursing services, pharmaceutical services, surgical care and hospital care, theassignment of the benefits of the contract by the applicant or recipient or alegally liable party shall, upon receipt of notice from the assignee, provideauthority for payment by the insurer directly to the assignee. If notice isprovided by the assignee to the insurer in accordance with the provisions ofW.S 42-4-204, the insurer shall be liable to the assignee for any amountpayable to the assignee under the contract.

 

ARTICLE 2 - INTERSTATE INSURANCE PRODUCT REGULATION

 

26-15-201. Interstate insurance product regulation compact.

 

The Interstate Insurance Product Regulation Compact ishereby enacted into law and entered into on behalf of this state with any andall other states legally joining therein in a form substantially as follows:

 

INTERSTATE INSURANCE PRODUCT REGULATIONCOMPACT

 

ARTICLEI

 

Purposes

 

(a) The purposes of this compact are, through means ofjoint and cooperative action among the compacting states:

 

(i) To promote and protect theinterest of consumers of individual and group annuity, life insurance,disability income and long-term care insurance products;

 

(ii) To develop uniform standardsfor insurance products covered under the compact;

 

(iii) To establish a centralclearinghouse to receive and provide prompt review of insurance productscovered under the compact and, in certain cases, advertisements relatedthereto, submitted by insurers authorized to do business in one or morecompacting states;

 

(iv) To give appropriateregulatory approval to those product filings and advertisements satisfying theapplicable uniform standard;

 

(v) To improve coordination of regulatory resources andexpertise between state insurance departments regarding the setting of uniformstandards and review of insurance products covered under the compact;

 

(vi) To create the interstate insurance product regulationcommission; and

 

(vii) To perform these and suchother related functions as may be consistent with the state regulation of thebusiness of insurance.

 

ARTICLE II

 

Definitions

 

(a) Notwithstanding W.S. 26-1-102, for purposes of this compact:

 

(i) "Advertisement" means any material designedto create public interest in a product, or induce the public to purchase,increase, modify, reinstate, borrow on, surrender, replace or retain a policy,as more specifically defined in the rules and operating procedures of thecommission;

 

(ii) "Bylaws" meansthose bylaws established by the commission for its governance, or for directingor controlling the commission's actions or conduct;

 

(iii) "Compacting state" means any state whichhas enacted this compact legislation and which has not withdrawn pursuant toarticle XIV, section 1, or been terminated pursuant to article XIV, section 2;

 

(iv) "Commission" means the "interstateinsurance product regulation commission" established by this compact;

 

(v) "Commissioner" means the chief insuranceregulatory official of a state including, but not limited to commissioner,superintendent, director or administrator;

 

(vi) "Domiciliary state" means the state inwhich an insurer is incorporated or organized or, in the case of an alieninsurer, its state of entry;

 

(vii) "Insurer" meansany entity licensed by a state to issue contracts of insurance for any of thelines of insurance covered by this compact;

 

(viii) "Member" meansthe person chosen by a compacting state as its representative to thecommission, or his or her designee;

 

(ix) "Noncompacting state" means any state whichis not at the time a compacting state;

 

(x) "Operatingprocedures" mean procedures promulgated by the commission implementing arule, uniform standard or a provision of this compact;

 

(xi) "Product" means theform of a policy or contract, including any application, endorsement or relatedform which is attached to and made a part of the policy or contract, and anyevidence of coverage or certificate, for an individual or group annuity, lifeinsurance, disability income or long-term care insurance product that aninsurer is authorized to issue;

 

(xii) "Rule" means astatement of general or particular applicability and future effect promulgatedby the commission, including a uniform standard developed pursuant to articleVII of this compact, designed to implement, interpret or prescribe law orpolicy or describing the organization, procedure or practice requirements ofthe commission, which shall have the force and effect of law in the compactingstates;

 

(xiii) "State" means any state, district or territory of the United Statesof America;

 

(xiv) "Third-party filer" means an entity that submits a product filing tothe commission on behalf of an insurer;

 

(xv) "Uniform standard" means a standard adopted by the commission for aproduct line, pursuant to article VII of this compact, and shall include all ofthe product requirements in aggregate, provided, that each uniform standardshall be construed, whether express or implied, to prohibit the use of anyinconsistent, misleading or ambiguous provisions in a product and the form ofthe product made available to the public shall not be unfair, inequitable oragainst public policy as determined by the commission.

 

ARTICLEIII

 

Establishmentof the commission and venue

 

(a) Thecompacting states hereby create and establish a joint public agency known asthe "interstate insurance product regulation commission." Pursuantto article IV, the commission will have the power to develop uniform standardsfor product lines, receive and provide prompt review of products filedtherewith and give approval to those product filings satisfying applicableuniform standards; provided, it is not intended for the commission to be theexclusive entity for receipt and review of insurance product filings. Nothingherein shall prohibit any insurer from filing its product in any state whereinthe insurer is licensed to conduct the business of insurance; and any suchfiling shall be subject to the laws of the state where filed.

 

(b) Thecommission is a body corporate and politic, and an instrumentality of thecompacting states.

 

(c) The commission is solely responsible for itsliabilities except as otherwise specifically provided in this compact.

 

(d) Venueis proper and judicial proceedings by or against the commission shall bebrought solely and exclusively in a court of competent jurisdiction where theprincipal office of the commission is located.

 

ARTICLEIV

 

Powersof the commission

 

(a) Thecommission shall have the following powers:

 

(i) Topromulgate rules, pursuant to article VII of this compact, which shall have theforce and effect of law and shall be binding in the compacting states to theextent and in the manner provided in this compact;

 

(ii) To exercise its rulemakingauthority and establish reasonable uniform standards for products covered underthe compact, and advertisement related thereto, which shall have the force andeffect of law and shall be binding in the compacting states, but only for thoseproducts filed with the commission, provided, that a compacting state shallhave the right to opt out of such uniform standard pursuant to article VII, tothe extent and in the manner provided in this compact, and, provided further,that any uniform standard established by the commission for long-term careinsurance products may provide the same or greater protections for consumersas, but shall not provide less than, those protections set forth in theNational Association of Insurance Commissioners' Long-Term Care Insurance ModelAct and Long-Term Care Insurance Model Regulation, respectively, adopted as of2001. The commission shall consider whether any subsequent amendments to theNational Association Of Insurance Commissioners' Long-Term Care Insurance ModelAct or Long-Term Care Insurance Model Regulation adopted by the nationalassociation of insurance commissioners require amending of the uniformstandards established by the commission for long-term care insurance products;

 

(iii) To receive and review in anexpeditious manner products filed with the commission, and rate filings fordisability income and long-term care insurance products, and give approval ofthose products and rate filings that satisfy the applicable uniform standard,where such approval shall have the force and effect of law and be binding onthe compacting states to the extent and in the manner provided in the compact;

 

(iv) To receive and review in anexpeditious manner advertisement relating to long-term care insurance productsfor which uniform standards have been adopted by the commission, and giveapproval to all advertisement that satisfies the applicable uniform standard. For any product covered under this compact, other than long-term care insuranceproducts, the commission shall have the authority to require an insurer tosubmit all or any part of its advertisement with respect to that product forreview or approval prior to use, if the commission determines that the natureof the product is such that an advertisement of the product could have thecapacity or tendency to mislead the public. The actions of commission asprovided in this section shall have the force and effect of law and shall bebinding in the compacting states to the extent and in the manner provided inthe compact;

 

(v) To exercise its rulemakingauthority and designate products and advertisement that may be subject to aself-certification process without the need for prior approval by thecommission;

 

(vi) To promulgate operatingprocedures, pursuant to article VII of this compact, which shall be binding inthe compacting states to the extent and in the manner provided in this compact;

 

(vii) To bringand prosecute legal proceedings or actions in its name as the commission;provided, that the standing of any state insurance department to sue or be suedunder applicable law shall not be affected;

 

(viii) To issue subpoenas requiring the attendance andtestimony of witnesses and the production of evidence;

 

(ix) To establishand maintain offices;

 

(x) To purchaseand maintain insurance and bonds;

 

(xi) To borrow, accept or contract for services ofpersonnel, including, but not limited to, employees of a compacting state;

 

(xii) To hire employees,professionals or specialists, and elect or appoint officers, and to fix theircompensation, define their duties and give them appropriate authority to carryout the purposes of the compact, and determine their qualifications; and toestablish the commission's personnel policies and programs relating to, amongother things, conflicts of interest, rates of compensation and qualificationsof personnel;

 

(xiii) To accept any and allappropriate donations and grants of money, equipment, supplies, materials andservices, and to receive, utilize and dispose of the same; provided that at alltimes the commission