376.1094. Certificate of authority, suspension or revocation, grounds--civil action, when.
Certificate of authority, suspension or revocation, grounds--civilaction, when.
376.1094. 1. The director shall suspend or revoke the certificate ofauthority of an administrator if the director finds that the administrator:
(1) Is in an unsound financial condition;
(2) Is using such methods or practices in the conduct of its businessso as to render its further transaction of business in this state hazardousor injurious to insured persons or the public; or
(3) Has failed to satisfy any judgment rendered against it in thisstate within sixty days after the judgment has become final.
2. The director may, in his discretion, suspend or revoke thecertificate of authority of an administrator if the director finds that theadministrator or any of its officers, directors or any individualresponsible for the conduct of its affairs as described in subdivision (3)of subsection 2 of section 376.1092:
(1) Has violated any lawful rule or order of the director or anyprovision of the insurance laws of this state;
(2) Has refused to be examined or to produce its accounts, recordsand files for examination, or if any of its officers has refused to giveinformation with respect to its affairs or has refused to perform any otherlegal obligation as to such examination, when required by the director;
(3) Has, without just cause, refused to pay proper claims or performservices arising under its contracts or has, without just cause, causedcovered individuals to accept less than the amount due them or causedcovered individuals to employ attorneys or bring suit against theadministrator to secure full payment or settlement of such claims;
(4) Is affiliated with or under the same general management orinterlocking directorate or ownership as another administrator or insurerwhich unlawfully transacts business in this state without having acertificate of authority;
(5) At any time fails to meet any qualification for which issuance ofthe certificate could have been refused had such failure then existed andbeen known to the department;
(6) Has been convicted of, or has entered a plea of guilty or nolocontendere to, a felony without regard to whether adjudication waswithheld;
(7) Is not competent, trustworthy, financially responsible or of goodpersonal and business reputation, has had an insurance or administratorlicense denied for cause by any state or been subject to any form ofadministrative, civil or criminal action by any federal or state agency orcourt resulting in some form of discipline or sanction; or
(8) Is under suspension or revocation in another state.
3. The director may, in his discretion and without advance notice orhearing thereon, immediately suspend the certificate of any administratorif the director finds that one or more of the following circumstancesexist:
(1) The administrator is insolvent or impaired;
(2) A proceeding for receivership, conservatorship, rehabilitation,or other delinquency proceeding regarding the administrator has beencommenced in any state;
(3) The financial condition or business practices of theadministrator otherwise poses an imminent threat to the public health,safety or welfare of the residents of this state.
4. If the director determines that a person has engaged, is engagingin, or has taken a substantial step toward engaging in an act, practice orcourse of business constituting a violation of sections 376.1075 to376.1095 or a rule adopted or order issued pursuant thereto, or that aperson has materially aided or is materially aiding an act, practice,omission, or course of business constituting a violation of sections376.1075 to 376.1095 or a rule adopted or order issued pursuant thereto,the director may issue such administrative orders as authorized undersection 374.046, RSMo. A violation of any of these sections is a levelthree violation under section 374.049, RSMo.
5. If the director believes that a person has engaged, is engagingin, or has taken a substantial step toward engaging in an act, practice orcourse of business constituting a violation of sections 376.1075 to376.1095 or a rule adopted or order issued pursuant thereto, or that aperson has materially aided or is materially aiding an act, practice,omission, or course of business constituting a violation of sections376.1075 to 376.1095 or a rule adopted or order issued pursuant thereto,the director may maintain a civil action for relief authorized undersection 374.048, RSMo. A violation of any of these sections is a levelthree violation under section 374.049, RSMo.
(L. 1993 H.B. 709 § 53, A.L. 2007 S.B. 66)