Association account: means the Utah Property and Casualty Insurance Guaranty Association Account created by Section 31A-28-205. See Utah Code 31A-28-203
an insurer is unable to pay the insurer's obligations as the obligations are due;
(b)
an insurer's total adjusted capital is less than the insurer's mandatory control level RBC under Subsection 31A-17-601(8)(c); or
(c)
an insurer's admitted assets are less than the insurer's liabilities. See Utah Code 31A-1-301
Insolvent insurer: means a member insurer that is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency. See Utah Code 31A-28-203
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:
Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
Member: means a person having membership rights in an insurance corporation. See Utah Code 31A-1-301
Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
Reinsurer: means a person licensed in this state as an insurer with the authority to assume reinsurance. 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
(2)
“Association account” means the Utah Property and Casualty Insurance Guaranty Association Account created by Section 31A-28-205.
(3)
(a)
“Claimant” means:
(i)
an insured making a first-party claim; or
(ii)
a person instituting a liability claim.
(b)
A person who is an affiliate of the insolvent insurer may not be a claimant.
(4)
(a)
“Covered claim” means an unpaid claim, including an unpaid claim under a personal lines policy for unearned premiums submitted by a claimant, if:
(i)
the claim arises out of the coverage;
(ii)
the claim is within the coverage;
(iii)
the claim is not in excess of the applicable limits of an insurance policy to which this part applies;
(iv)
the insurer who issued the policy becomes an insolvent insurer; and
(v)
(A)
the claimant or insured is a resident of this state at the time of the insured event; or
(B)
the claim is a first-party claim for damage to property that is permanently located in this state.
(b)
“Covered claim” does not include:
(i)
any amount awarded as punitive or exemplary damages or any amount due any reinsurer, insurer, insurance pool, or underwriting association, as subrogation recoveries or otherwise, nor does it include any supplementary payment obligation, including adjustment fees and expenses, attorneys’ fees and expenses, court costs, interest, and bond premiums, prior to the appointment of a liquidator;
(ii)
any amount sought as a return of premium under a retrospective rating plan;
(iii)
any first-party claim by an insured if:
(A)
the insured’s net worth exceeds $25,000,000 on December 31 of the year preceding the date the insurer becomes an insolvent insurer; and
(B)
the insured’s net worth includes the aggregate net worth of the insured and all of its subsidiaries as calculated on a consolidated basis; or
(iv)
any first-party claims by an insured that is an affiliate of the insolvent insurer.
(5)
“Insolvent insurer” means a member insurer that is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency.
(6)
“Member insurer” means any person who:
(a)
writes any kind of insurance to which this part applies under Section 31A-28-202, including the exchange of reciprocal or inter-insurance contracts; and
(b)
is licensed to transact insurance in this state.
(7)
(a)
“Net direct written premiums” means direct gross premiums written in this state on insurance policies that this part applies to, less return premiums and dividends paid or credited to policyholders on the direct business.
(b)
“Net direct written premiums” does not include premiums on contracts between insurers or reinsurers.
(8)
“Personal lines policy” means an insurance policy issued to an individual that:
(a)
insures a motor vehicle used for personal purposes and not used in trade or business; or
(b)
insures a residential dwelling.
(9)
“Residence” means, for entities other than a natural person, the state where the principal place of business of a claimant, insured, or policyholder is located at the time of the insured event.
