375.778. Claims of insured, recovery, procedures--assignment of rights to association, when, extent of--stay of proceedings against insolvent insurer, when--records of insolvent insurer, access by boa
Claims of insured, recovery, procedures--assignment of rights toassociation, when, extent of--stay of proceedings against insolventinsurer, when--records of insolvent insurer, access by board, when.
375.778. 1. Any person having a claim against an insurer, regardlessof whether such insurer is a member insurer, under any provision in aninsurance policy, other than the policy of the insolvent insurer, whicharises out of the same facts, injury, or loss that gave rise to the coveredclaim against the association and which is also a covered claim shall berequired to first exhaust his or her right under such policy or policies ofinsurance. Such other policies of insurance shall include, but not belimited to, liability coverage, health and accident insurance,hospitalization and other medical expense coverage, health care coverage bya health maintenance organization or health services corporation, or anyamount payable by or on behalf of a self-insured plan, workers'compensation benefits, disability insurance, uninsured motorist coverage,and underinsured motorist coverage. The association's obligation pursuantto subsection 1 of section 375.775 shall be reduced by the amount recoveredor recoverable, whichever is greater under any such other insurance policyor policies. To the extent the association's obligation pursuant tosubsection 1 of section 375.775 is reduced by the application of thesection, the liability of the person insured by the insolvent insurer'spolicy for the claim shall be reduced in the same amount.
2. Any person having a claim which may be recovered under more thanone insurance guaranty association or its equivalent shall first seekrecovery from the association of the place of residence of the insuredexcept that if it is a first party claim for damage to property with apermanent location, from the association of the location of the property,and if it is a workers' compensation claim, from the association of theresidence of the claimant. Any recovery under sections 375.771 to 375.779shall be reduced by the amount of the recovery from any other insuranceguaranty association or its equivalent.
3. Any person having a claim or legal right of recovery against anygovernmental insurance or guaranty program that is also a covered claimshall be required to exhaust first such rights under that program. Anyamount payable on a covered claim by the association shall be reduced bythe amount of recovery under the program.
4. The association shall have no duty to provide a separate defenseat its cost to an insured of an insolvent insurer as to any issue arisingout of the coverage of this section.
5. (1) Any person recovering under sections 375.771 to 375.779 shallbe deemed to have assigned his or her rights under the policy to theassociation to the extent of his or her recovery from the association.Every insured or claimant seeking the protection of sections 375.771 to375.779 shall cooperate with the association to the same extent as suchperson would have been required to cooperate with the insolvent insurer.
(2) The association shall periodically file with the receiver orliquidator of the insolvent insurer statements of the covered claims paidby the association and estimates of anticipated claims on the associationwhich shall preserve the rights of the association against the assets ofthe insolvent insurer.
6. All proceedings in which the insolvent insurer is a party or isobligated to defend a party in any court of this state shall, subject towaiver by the association in specific cases involving covered claims, bestayed until the last day fixed by the court for the filing of claims andsuch additional time thereafter as may be determined by the court from thedate the insolvency is determined or an ancillary proceeding is institutedin the state, whichever is later, to permit proper defense by theassociation of all pending causes of action.
7. As to any covered claims arising from a judgment under anydecision, verdict or finding based on the default of the insolvent insureror its failure to defend an insured, the association, either on its ownbehalf or on behalf of such insured, may apply to have such judgment,order, decision, verdict or finding set aside by the same court oradministrator that made such judgment, order, decision, verdict or findingand shall be permitted to defend against such claim on the merits.
8. With respect to a subrogation claim arising out of payment forproperty damage caused by a tortfeasor insured by an insolvent insurer, theinsurer making such payment shall not be entitled to any right of recoveryagainst such tortfeasor in excess of the proceeds recovered from the assetsof the insolvent insurer of such tortfeasor; provided that, such limitationshall not apply with respect to property damage in excess of the limits ofliability of the policy issued such tortfeasor by the insolvent insurer.
9. The liquidator, receiver, or statutory receiver of an insolventmember insurer covered by sections 375.771 to 375.779 shall permit accessby the board of directors of the association or its authorizedrepresentative to such of the insolvent insurer's records which arenecessary for the board in carrying out its functions under sections375.771 to 375.779 with regard to covered claims. In addition, theliquidator, receiver, or statutory receiver shall provide the board or itsrepresentatives with copies of such records upon the request by the boardand at the expense of the board.
(L. 1989 S.B. 333, A.L. 1992 H.B. 1574, A.L. 2004 S.B. 1299)