58-3-100. Insurance company licensing provisions.
(a) The Commissioner may, after notice and opportunity for a hearing, revoke, suspend, or restrict the license of any insurer if:
(1) The insurer fails or refuses to comply with any law, order or rule applicable to the insurer.
(2) After considering the standards under G.S. 58-30-60(b), the Commissioner determines that the continued operation of the insurer is hazardous to its policyholders, to its creditors, or to the general public.
(3) The insurer has published or made to the Department or to the public any false statement or report.
(4) The insurer or any of the insurer's officers, directors, employees, or other representatives refuse to submit to any examination authorized by law or refuse to perform any legal obligation in relation to an examination.
(5) The insurer is found to make a practice of unduly engaging in litigation or of delaying the investigation of claims or the adjustment or payment of valid claims.
(b) Any suspension, revocation or refusal to renew an insurer's license under this section may also be made applicable to the license or registration of any individual regulated under this Chapter who is a party to any of the causes for licensing sanctions listed in subsection (a) of this section.
(c) The Commissioner may impose a civil penalty under G.S. 58-2-70 if an HMO, service corporation, MEWA, or insurer fails to acknowledge a claim within 30 days after receiving written or electronic notice of the claim, but only if the notice contains sufficient information for the insurer to identify the specific coverage involved. Acknowledgement of the claim shall be one of the following:
(1) A statement made to the claimant or to the claimant's legal representative advising that the claim is being investigated.
(2) Payment of the claim.
(3) A bona fide written offer of settlement.
(4) A written denial of the claim.
(d) If a foreign insurance company's license is suspended or revoked, the Commissioner shall cause written notification of the suspension or revocation to be given to all of the company's agents in this State. Until the Commissioner restores the company's license, the company shall not write any new business in this State.
(e) The Commissioner may, after considering the standards under G.S. 58-30-60(b), restrict an insurer's license by prohibiting or limiting the kind or amount of insurance written by that insurer. For a foreign insurer, this restriction relates to the insurer's business conducted in this State. The Commissioner shall remove any restriction under this subsection once the Commissioner determines that the operations of the insurer are no longer hazardous to the public or the insurer's policyholders or creditors. As used in this subsection, "insurer" includes an HMO, service corporation, and MEWA. (1899, c. 54, ss. 66, 75, 112; 1901, c. 391, s. 5; Rev., ss. 4703, 4705; C.S., s. 6297; 1947, c. 721; 1963, c. 1234; 1993, c. 409, s. 1; 1995, c. 193, s. 10; 1999-294, s. 9; 2000-162, s. 4(b); 2001-223, s. 2.2; 2001-334, s. 15; 2003-212, s. 26(a); 2005-215, s. 2; 2005-223, s. 7.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 3 - General Regulations for Insurance.
§ 58-3-1 - State law governs insurance contracts.
§ 58-3-5 - No insurance contracts except under Articles 1 through 64 of this Chapter.
§ 58-3-6 - Charitable gift annuities.
§ 58-3-7 - Certain accountable care organizations not subject to this Chapter.
§ 58-3-8 - Medical direct primary care agreements not subject to this Chapter.
§ 58-3-10 - Statements in application not warranties.
§ 58-3-15 - Additional or coinsurance clause.
§ 58-3-20 - Group plans other than life, annuity or accident and health.
§ 58-3-25 - Discriminatory practices prohibited.
§ 58-3-30 - Meaning of terms "accident", "accidental injury", and "accidental means".
§ 58-3-33 - Insurer conditionally required to provide information.
§ 58-3-35 - Stipulations as to jurisdiction and limitation of actions.
§ 58-3-40 - Proof of loss forms required to be furnished.
§ 58-3-45 - Insurance as security for a loan by the company.
§ 58-3-50 - Companies must do business in own name; emblems, insignias, etc.
§ 58-3-55 - Must not pay death benefits in services.
§ 58-3-60 - Publication of assets and liabilities; penalty for failure.
§ 58-3-65 - Publication of financial information.
§ 58-3-71 - Unearned premium reserves.
§ 58-3-72 - Premium deficiency reserves.
§ 58-3-75 - Loss and loss expense reserves of fire and marine insurance companies.
§ 58-3-81 - Loss and loss expense reserves of casualty insurance and surety companies.
§ 58-3-100 - Insurance company licensing provisions.
§ 58-3-105 - Limitation of risk.
§ 58-3-110 - Limitation of liability assumed.
§ 58-3-115 - Twisting with respect to insurance policies; penalties.
§ 58-3-120 - Discrimination forbidden.
§ 58-3-121 - Discrimination against coverage of certain bones and joints prohibited.
§ 58-3-135 - Certain insurance activities by lenders with customers prohibited.
§ 58-3-137 - Prohibition on provisions relating to replacement cost estimators.
§ 58-3-140 - Temporary contracts of insurance permitted.
§ 58-3-145 - Solicitation, negotiation or payment of premiums on insurance policies.
§ 58-3-147 - Credit card guaranty or collateral prohibited.
§ 58-3-149 - Certificates of insurance.
§ 58-3-150 - Forms to be approved by Commissioner.
§ 58-3-151 - Deemer provisions.
§ 58-3-152 - Excess liability policies; uninsured and underinsured motorist coverages.
§ 58-3-155 - Business transacted with insurer-controlled brokers.
§ 58-3-160 - Sale of company or major reorganization; license to be restricted.
§ 58-3-165 - Business transacted with producer-controlled property or casualty insurers.
§ 58-3-167 - Applicability of acts of the General Assembly to health benefit plans.
§ 58-3-168 - Coverage for postmastectomy inpatient care.
§ 58-3-169 - Required coverage for minimum hospital stay following birth.
§ 58-3-170 - Requirements for maternity coverage.
§ 58-3-171 - Uniform claim forms.
§ 58-3-172 - Notice of claim denied.
§ 58-3-175 - Direct payment to government agencies.
§ 58-3-176 - Treatment discussions not limited.
§ 58-3-177 - Uniform prescription drug identification cards.
§ 58-3-179 - Coverage for colorectal cancer screening.
§ 58-3-180 - Motor vehicle repairs; selection by claimant.
§ 58-3-181 - Synchronization of prescription refills.
§ 58-3-185 - Lien created for payment of past-due child support obligations.
§ 58-3-190 - Coverage required for emergency care.
§ 58-3-191 - Managed care reporting and disclosure requirements.
§ 58-3-192 - Coverage for autism spectrum disorder.
§ 58-3-200 - Miscellaneous insurance and managed care coverage and network provisions.
§ 58-3-215 - Genetic information in health insurance.
§ 58-3-220 - Mental illness benefits coverage.
§ 58-3-221 - Access to nonformulary and restricted access prescription drugs.
§ 58-3-223 - Managed care access to specialist care.
§ 58-3-225 - Prompt claim payments under health benefit plans.
§ 58-3-227 - Health plans fee schedules.
§ 58-3-228 - Coverage for extra prescriptions during a state of emergency or disaster.
§ 58-3-230 - Uniform provider credentialing.
§ 58-3-231 - Payment under locum tenens arrangements.
§ 58-3-235 - Selection of specialist as primary care provider.
§ 58-3-240 - Direct access to pediatrician for minors.
§ 58-3-245 - Provider directories; cost tools for insured.
§ 58-3-247 - Insurance identification card.
§ 58-3-250 - Payment obligations for covered services.
§ 58-3-255 - Coverage of clinical trials.
§ 58-3-256 - Coverage related to organ transplants.
§ 58-3-260 - Insurance coverage for newborn hearing screening mandated.
§ 58-3-265 - Prohibition on managed care provider incentives.
§ 58-3-270 - Coverage for surveillance tests for women at risk for ovarian cancer.
§ 58-3-275 - Closure of a block of business.
§ 58-3-280 - Coverage for the diagnosis and treatment of lymphedema.
§ 58-3-285 - Coverage for hearing aids.
§ 58-3-290 - Nondependent child coverage defined; open enrollment.
§ 58-3-300 - Health insurance issuers subject to certain requirements of federal law.