687A.033 - “Covered claim” defined.
687A.033 “Covered claim” defined.
1. “Covered claim” means an unpaid claim or judgment, including a claim for unearned premiums, which arises out of and is within the coverage of an insurance policy to which this chapter applies issued by an insurer which becomes an insolvent insurer, if one of the following conditions exists:
(a) The claimant or insured, if a natural person, is a resident of this State at the time of the insured event.
(b) The claimant or insured, if other than a natural person, maintains its principal place of business in this State at the time of the insured event.
(c) The property from which the first party property damage claim arises is permanently located in this State.
(d) The claim is not a covered claim pursuant to the laws of any other state and the premium tax imposed on the insurance policy is payable in this State pursuant to NRS 680B.027.
2. The term does not include:
(a) An amount that is directly or indirectly due a reinsurer, insurer, insurance pool or underwriting association, as recovered by subrogation, indemnity or contribution, or otherwise.
(b) That part of a loss which would not be payable because of a provision for a deductible or a self-insured retention specified in the policy.
(c) Except as otherwise provided in this paragraph, any claim filed with the Association:
(1) More than 18 months after the date of the order of liquidation; or
(2) After the final date set by the court for the filing of claims against the liquidator or receiver of the insolvent insurer,
Ê whichever is earlier. The provisions of this paragraph do not apply to a claim for workers’ compensation that is reopened pursuant to the provisions of NRS 616C.390 or 616C.392.
(d) A claim filed with the Association for a loss that is incurred but is not reported to the Association before the expiration of the period specified in subparagraph (1) or (2) of paragraph (c).
(e) An obligation to make a supplementary payment for adjustment or attorney’s fees and expenses, court costs or interest and bond premiums incurred by the insolvent insurer before the appointment of a liquidator, unless the expenses would also be a valid claim against the insured.
(f) A first party or third party claim brought by or against an insured, if the aggregate net worth of the insured and any affiliate of the insured, as determined on a consolidated basis, is more than $25,000,000 on December 31 of the year immediately preceding the date the insurer becomes an insolvent insurer. The provisions of this paragraph do not apply to a claim for workers’ compensation. As used in this paragraph, “affiliate” means a person who directly or indirectly owns or controls, is owned or controlled by, or is under common ownership or control with, another person. For the purpose of this definition, the terms “owns,” “is owned” and “ownership” mean ownership of an equity interest, or the equivalent thereof, of 10 percent or more.
(Added to NRS by 1985, 1072; A 1987, 1065; 1989, 565; 1993, 1396; 1999, 2521; 2001, 2215; 2003, 3307; 2005, 1497)