31A-22-1903.  Insurer conduct.

(1)  An insurer shall perform a comparison of its insureds’ in-force policies, contracts, and retained asset accounts against a death master file, on at least a semi-annual basis, by using the full death master file once and thereafter using the death master file update files for future comparisons to identify potential matches of its insureds. For those potential matches identified as a result of a death master file match:

Terms Used In Utah Code 31A-22-1903

  • Administrator: means the same as that term is defined in Section 67-4a-102. See Utah Code 31A-22-1902
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Annuity: means an agreement to make periodical payments for a period certain or over the lifetime of one or more individuals if the making or continuance of all or some of the series of the payments, or the amount of the payment, is dependent upon the continuance of human life. See Utah Code 31A-1-301
  • Asymmetric conduct: means an insurer's use of the death master file or other similar database before July 1, 2015, in connection with searching for information regarding whether annuitants under the insurer's annuities might be deceased, but not in connection with whether the insureds under the insurer's policies might be deceased. See Utah Code 31A-22-1902
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Certificate: means evidence of insurance given to:
(a) an insured under a group insurance policy; or
(b) a third party. See Utah Code 31A-1-301
  • Contract: means an annuity contract. See Utah Code 31A-22-1902
  • Contract: A legal written agreement that becomes binding when signed.
  • Death master file: means the United States Social Security Administration's Death Master File or another database or service that is at least as comprehensive as the United States Social Security Administration's Death Master File for determining that a person has reportedly died. See Utah Code 31A-22-1902
  • Death master file match: means a search of a death master file that results in a match of the Social Security number, or the name and date of birth of an insured, annuity owner, or retained asset account holder. See Utah Code 31A-22-1902
  • Insurance: includes :
    (i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
    (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
    (iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
  • Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
    (i) a policyholder;
    (ii) a subscriber;
    (iii) a member; and
    (iv) a beneficiary. See Utah Code 31A-1-301
  • Person: includes :
    (a) an individual;
    (b) a partnership;
    (c) a corporation;
    (d) an incorporated or unincorporated association;
    (e) a joint stock company;
    (f) a trust;
    (g) a limited liability company;
    (h) a reciprocal;
    (i) a syndicate; or
    (j) another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301
  • Policy: means a policy or certificate of life insurance that provides a death benefit. See Utah Code 31A-22-1902
  • Property: includes both real and personal property. See Utah Code 68-3-12.5
  • Retained asset account: means a mechanism whereby the settlement of proceeds payable under a policy or contract is accomplished by the insurer or an entity acting on behalf of the insurer by depositing the proceeds into an account with check or draft writing privileges, where those proceeds are retained by the insurer or its agent, pursuant to a supplementary contract not involving annuity benefits other than death benefits. See Utah Code 31A-22-1902
  • Security: means a:
    (i) note;
    (ii) stock;
    (iii) bond;
    (iv) debenture;
    (v) evidence of indebtedness;
    (vi) certificate of interest or participation in a profit-sharing agreement;
    (vii) collateral-trust certificate;
    (viii) preorganization certificate or subscription;
    (ix) transferable share;
    (x) investment contract;
    (xi) voting trust certificate;
    (xii) certificate of deposit for a security;
    (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in payments out of production under such a title or lease;
    (xiv) commodity contract or commodity option;
    (xv) certificate of interest or participation in, temporary or interim certificate for, receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in Subsections (171)(a)(i) through (xiv); or
    (xvi) another interest or instrument commonly known as a security. See Utah Code 31A-1-301
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
  • (a)  The insurer shall within 90 days of a death master file match:

    (i)  complete a good faith effort, that the insurer documents, to confirm the death of the insured or retained asset account holder against other available records and information; and

    (ii)  determine whether benefits are due in accordance with the applicable policy or contract, and if benefits are due in accordance with the applicable policy or contract:

    (A)  use good faith efforts, that the insurer documents, to locate the beneficiary or beneficiaries; and

    (B)  provide the appropriate claims forms or instructions to the beneficiary or beneficiaries to make a claim including the need to provide an official death certificate, if applicable under the policy or contract.

    (b)  With respect to group life insurance, an insurer shall confirm the possible death of an insured when the insurer maintains at least the following information of those covered under a policy or certificate:

    (i)  social security number, or name and date of birth;

    (ii)  beneficiary designation information;

    (iii)  coverage eligibility;

    (iv)  benefit amount; and

    (v)  premium payment status.

    (c)  An insurer shall implement procedures to account for:

    (i)  initials used in lieu of a first or middle name, use of a middle name, compound first and middle names, and interchanged first and middle names;

    (ii)  compound last names, hyphens, and blank spaces or apostrophes in last names; and

    (iii)  transposition of the “month” and “date” portions of the date of birth.

    (d)  To the extent permitted by law, the insurer may disclose minimum necessary personal information about the insured or beneficiary to a person who the insurer reasonably believes may be able to assist the insurer locate the beneficiary or a person otherwise entitled to payment of the claims proceeds.
  • (2) 

    (a)  An insurer that has not engaged in asymmetric conduct before July 1, 2015, is not required to comply with the requirements of this section with respect to a policy, annuity, or retained asset account issued or delivered before July 1, 2015.

    (b)  Notwithstanding Subsection (2)(a), an insurer, regardless of whether it has engaged in asymmetric conduct, shall comply with the requirements of this section for a policy, annuity, or retained asset account issued on or after July 1, 2015.

    (3)  An insurer or the insurer’s service provider may not charge a beneficiary or other authorized representative for fees or costs associated with a death master file search or verification of a death master file match conducted pursuant to this section.

    (4)  The benefits from a policy, contract, or retained asset account, plus any applicable accrued contractual interest shall first be payable to the designated beneficiaries or owners and in the event said beneficiaries or owners can not be found, shall be transferred to the state as unclaimed property pursuant to Subsection 67-4a-201(8). Interest payable under Section 31A-22-428 may not be payable as unclaimed property under Subsection 67-4a-201(8) .

    (5)  An insurer shall notify the administrator upon the expiration of the statutory holding period under Subsection 67-4a-201(8) that:

    (a)  a policy, contract beneficiary, or retained asset account holder has not submitted a claim with the insurer; and

    (b)  the insurer has complied with Subsection (1) and has been unable, after good faith efforts documented by the insurer, to contact the retained asset account holder, beneficiary, or beneficiaries.

    (6)  Upon such notice, an insurer shall immediately submit the unclaimed policy or contract benefits or unclaimed retained asset accounts, plus any applicable accrued interest, to the administrator.

    Amended by Chapter 459, 2018 General Session