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Defining Standards and Commissioner's Authority for Companies Deemed to Be in Hazardous Financial Condition

Reg. I-1993-02 (Revised)
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Section 1.  Authority.

This regulation is promulgated pursuant to the authority granted by 8 V.S.A. § 15 and Chapters 101, 123, 125, 139, 141, 142, 145 and 151.

Section 2.  Purpose.

The purpose of this regulation is to set forth the standards which the Commissioner may use for identifying, and the powers and authority of the Commissioner with respect to, insurers or other risk bearing entities found to be in such condition as to render the continuance of their business hazardous to the public or to holders of their policies or certificates of insurance.

This regulation shall not be interpreted to limit the powers granted to the Commissioner by any laws or parts of laws of this state, nor shall this regulation be interpreted to supersede any laws or parts of laws of this state.

Section 3.  Standards.

The following standards, either singly or a combination of two or more, may be considered by the Commissioner to determine whether the continued operation of any insurer transacting an insurance business in this state might be deemed to be hazardous to the policyholders, creditors or the general public. The Commissioner may consider:

A.  Adverse findings reported in financial condition and market conduct examination reports, audit reports, and actuarial opinions, reports or summaries;
B.  The National Association of Insurance Commissioners Insurance Regulatory Information System and its other financial analysis solvency tools and reports;
C.  The ratios of commission expense, general insurance expense, policy benefits and reserve increases as to annual premium and net investment income which could lead to an impairment of capital and surplus;
D.  Whether the insurer's asset portfolio when viewed in light of current economic conditions is not of sufficient value, liquidity, or diversity to assure the company's ability to meet its outstanding obligations as they mature;
E.  Whether the insurer has made adequate provision, according to presently accepted actuarial standards of practice, for the anticipated cash flows required by the contractual obligations and related expenses of the insurer, when considered in light of the assets held by the insurer with respect to such reserves and related actuarial items including, but not limited to, the investment earnings on such assets, and the considerations anticipated to be received and retained under such policies and contracts;
F.  The ability of an assuming reinsurer to perform and whether the insurer's reinsurance program provides sufficient protection for the company's remaining surplus after taking into account the insurer's cash flow and the classes of business written as well as the financial condition of the assuming reinsurer;
G.  Whether the insurer's operating loss in the last 12-month period or any shorter period of time including, but not limited to, net capital gain or loss, change in non-admitted assets, and cash dividends paid to shareholders, is greater than 50% of the insurer's remaining surplus as regards policyholders that is in excess of the minimum required;
H.  Whether the insurer's operating loss in the last 12-month period or any shorter period of time, excluding net capital gains, is greater than 20% of the insurer's remaining surplus as regards policyholders in excess of the minimum required;
I.  Whether a reinsurer, obligor or any entity within the insurer's insurance holding company system, is insolvent, threatened with insolvency or delinquent in payment of its monetary or other obligations, and which in the opinion of the Commissioner may affect the solvency of the insurer including, but not limited to, whether transactions among affiliates, subsidiaries or controlling persons for which the insurer receives assets or capital gains, or both, do not provide sufficient value, liquidity or diversity to assure the insurer's ability to meet its outstanding obligations as they mature;
J.  Contingent liabilities, pledges or guarantees which either individually or collectively involve a total amount which in the opinion of the Commissioner may affect the solvency of the insurer;
K.  Whether any "controlling person" of an insurer is delinquent in the transmitting to, or payment of, net premiums to such insurer;
L.  Whether the age and collectability of receivables involve a total amount which the Commissioner determines adversely affects the solvency of the insurer;
M.  Whether the management of an insurer, including officers, directors, or any other person who directly or indirectly controls the operation of such insurer, fails to possess and demonstrate the competence, fitness and reputation deemed necessary to serve the insurer in such position;
N.  Whether management of an insurer has failed to respond to inquiries relative to the condition of the insurer or has furnished false and misleading information concerning an inquiry including, but not limited to, whether the insurer has failed to meet financial and holding company filing requirements in the absence of a reason satisfactory to the Commissioner;
O.  Whether management of an insurer either has filed any false or misleading sworn financial statement, or has released false or misleading financial statement to lending institutions or to the general public, or has made a false or misleading entry, or has omitted an entry of material amount in the books of the insurer;
P.  Whether the insurer has grown so rapidly and to such an extent that it lacks adequate financial and administrative capacity to meet its obligations in a timely manner;
Q.  Whether the company has experienced or will experience in the foreseeable future cash flow and/or liquidity problems including, but not limited to, whether management has established reserves that do not comply with minimum standards established by state insurance laws, regulations, statutory accounting standards, sound actuarial principles and standards of practice or whether management persistently engages in material under reserving that results in adverse development;
R.  Any other finding determined by the Commissioner to be hazardous to the insurer's policyholders, creditors or general public.
Section 4.  Commissioner's Authority.
A.  For the purposes of making a determination of an insurer's financial condition under this regulation, the Commissioner may:
(1)  Disregard any credit or amount receivable resulting from transactions with a reinsurer which is insolvent, impaired or otherwise subject to a delinquency proceeding;
(2)  Make appropriate adjustments including disallowance to asset values attributable to investments in or transactions with parents, subsidiaries, or affiliates consistent with the NAIC Accounting Practices and Procedures Manual, state laws and regulations;
(3)  Refuse to recognize the stated value of accounts receivable if the ability to collect receivables is highly speculative in view of the age of the account or the financial condition of the debtor;
(4)  Increase the insurer's liability in an amount equal to any contingent liability, pledge or guarantee not otherwise included if there is a substantial risk that the insurer will be called upon to meet the obligation undertaken within the next 12-month period.
B.  If the Commissioner determines that the continued operation of the insurer licensed to transact business in this state may be hazardous to the policyholders, creditors or the general public, then the Commissioner may, upon his or her determination, issue an order requiring the insurer to:
(1)  Reduce the total amount of present and potential liability for policy benefits by reinsurance;
(2)  Reduce, suspend or limit the volume of business being accepted or renewed;
(3)  Reduce general insurance and commission expenses by specified methods;
(4)  Increase the insurer's capital and surplus;
(5)  Suspend or limit the declaration and payment of dividend by an insurer to its stockholders or to its policyholders;
(6)  File reports in a form acceptable to the Commissioner concerning the market value of an insurer's assets;
(7)  Limit or withdraw from certain investments or discontinue certain investment practices to the extent the Commissioner deems necessary;
(8)  Document the adequacy of premium rates in relation to the risks insured;
(9)  File, in addition to regular annual statements, interim financial reports on the form adopted by the National Association of Insurance Commissioners or on such format as promulgated by the Commissioner;
(10)  Correct corporate governance practice deficiencies, and adopt and utilize governance practices acceptable to the Commissioner;
(11)  Provide a business plan to the Commissioner in order to continue to transact business in the state;
(12)  Adjust rates for any non-life insurance product written by the insurer that the Commissioner considers necessary to improve the financial condition of the insurer.

If the insurer is a foreign insurer, the Commissioner's order may be limited to the extent provided by statute.

C.  Any insurer subject to an order under Subsection B may request a hearing to review that order. The notice of hearing shall be served upon the insurer pursuant to 3 V.S.A. Chapter 25 and such hearing shall be subject to the requirements set forth in 8 V.S.A. § 7041, including, but not limited to, the provision for private hearing, unless insurer requests a public hearing.
Section 5.  Judicial Review.

Any order or decision of the Commissioner shall be subject to review in accordance with 8 V.S.A. § 16 at the instance of any party to the proceedings whose interests are substantially affected.

Section 6.  Separability.

If any provisions of this regulation be held invalid, the remainder shall not be affected.

Section 7.  Effective Date.

This regulation shall become effective October 16, 2014.