646.12(1)(b) (b) Chairperson. The person to chair the board shall be elected by the members of the board under a rule promulgated by the commissioner.
646.12(2) (2)General powers and duties. The board shall:
646.12(2)(a) (a) Subject to the commissioner's power to promulgate rules under sub. (1), adopt rules for the administration of this chapter, including delegation of any part of its powers and its own procedures.
646.12(2)(b) (b) Create standing or special committees as needed. A minority of the members of any committee may be persons not members of the board.
646.12(2)(c) (c) Delegate to the committees any of its powers and duties under this chapter, subject to review and reconsideration by the board.
646.12(2)(d) (d) Employ or retain the personnel necessary to carry out its duties and set compensation for the personnel, sue or be sued, make contracts and borrow money necessary to carry out its duties in the most efficient way, including money with which to pay claims under s. 646.31 or to continue coverage under s. 646.35. The board may offer as security for such loans its claims against the liquidator or its power to levy assessments under this chapter. Personnel employed under this paragraph are not employes of the state and are not subject to s. 20.922 or ch. 230.
646.12(2)(e) (e) Advise and make recommendations to the commissioner on any matter related to the possible insolvency of an insurer covered by this chapter, and respond to any reasonable questions presented by the commissioner. Information, recommendations and advice under this subsection are privileged and confidential and are not open to public inspection under s. 19.35 (1).
646.12(2)(f)1.1. Keep records of all meetings of the fund and of its subcommittees that involve discussions of the activities of the fund in carrying out its powers and duties under this chapter.
646.12(2)(f)2. 2. Keep confidential the records under subd. 1. pertaining to specific liquidation proceedings involving an insurer until the termination of the liquidation proceedings or until sooner ordered to make the records public by a court.
646.12(2)(f)3. 3. Keep confidential the records under subd. 1. pertaining to specific rehabilitation proceedings involving an insurer unless ordered to make the records public by a court.
646.12(2)(g) (g) Negotiate and contract with any liquidator to achieve the purposes of this chapter.
646.12(2)(h) (h) Perform other acts necessary to achieve the purposes of this chapter.
646.12(3) (3)Compensation. Members of the board and other committee members shall receive no compensation for services but may receive reimbursement for all reasonable and necessary expenses incurred in the performance of their respective duties as directors or as committee members.
646.12(4) (4)Other powers. The board may join an organization consisting of one or more entities of other states performing comparable functions, in order to assist the board in carrying out its powers and duties under this chapter and otherwise further the purposes of this chapter.
646.13 646.13 Special duties and powers of the board related to loss claims.
646.13(1)(1)Duties. The board shall:
646.13(1)(a) (a) Establish procedures and acceptable forms of proof for eligible claims, which shall correspond as closely as practicable with the corresponding rules under ch. 645.
646.13(1)(b) (b) Stand in the position of the insurer in the investigation, compromise, settlement, denial and payment of claims under s. 646.31 and the defense of 3rd party claims against insureds, subject to the limitations of s. 645.43. The board shall consult and cooperate with the liquidator in carrying out these duties. The board has no duties or liabilities with respect to any claim filed as follows:
646.13(1)(b)1. 1. With the liquidator under s. 645.61 after the date for filing specified by the liquidator under s. 645.47 (2), unless the liquidator determines that the claim is timely filed and participates in the same distribution as timely filed claims.
646.13(1)(b)2. 2. With a liquidator or court under the laws of any other state after the date for filing specified by the liquidator or court, unless the liquidator or court determines that the claim is timely filed and participates in the same distribution as timely filed claims.
646.13(2) (2)Powers. The board may:
646.13(2)(a) (a) Review settlements, releases and judgments to which the insurer or its insureds were parties to determine the extent to which they may be properly contested.
646.13(2)(b) (b) Exercise with respect to loss claims the powers that the liquidator has with respect to other claims under ch. 645.
646.13(2)(c) (c) With respect to any action against an insurer which is in liquidation, exercise the powers of the liquidator under s. 645.49 (1).
646.13(2)(d) (d) Have standing to appear in any liquidation proceedings in this state involving an insurer in liquidation.
646.13 History History: 1979 c. 109; 1985 a. 216; 1987 a. 325.
646.15 646.15 Proceedings involving nondomestic insurers.
646.15(1)(1)Injunctions and orders.
646.15(1)(a)(a) If a nondomestic insurer is in liquidation, the board may apply to the circuit court for Dane county for, and the court may grant, restraining orders, temporary and permanent injunctions, and other orders considered necessary and proper to prevent any of the following:
646.15(1)(a)1. 1. Interference with the board or with its administrative proceedings.
646.15(1)(a)2. 2. The institution or further prosecution of any action or proceeding involving the insurer.
646.15(1)(a)3. 3. The obtaining of a preference, judgment, garnishment or lien against the insurer or its assets.
646.15(1)(a)4. 4. Any other threatened or contemplated action that might prejudice the rights of policyholders or the administration of the liquidation or board proceedings.
646.15(1)(b) (b) Upon granting an application under par. (a), the court may retain jurisdiction of any further proceeding or relief, as the court considers necessary and proper, involving the insurer.
646.15(2) (2)Exclusive proceedings. A court of this state does not have jurisdiction to entertain, hear or determine a proceeding or to grant relief if the proceeding or relief involves or is related to a nondomestic insurer which is in liquidation unless the court is so authorized under this chapter or ch. 645.
646.15 History History: 1987 a. 325.
646.21 646.21 Custody and investment of assets.
646.21(1) (1)Custody. Except as provided in sub. (2), the board controls the assets of the fund. The board shall select regulated financial institutions in this state which receive deposits in which to establish and maintain accounts for assets needed on a current basis. If practicable, the accounts shall earn interest.
646.21(2) (2)Investment of assets. The board may request that assets of the fund not needed currently be invested by the investment board under s. 25.17. If so requested, the investment board shall invest those assets in investments with maturities and liquidity appropriate to the probable needs of the fund for money to perform its duties. All income attributable to the investments shall be credited to the fund, and both income and principal shall be transferred to the board of the fund on request of the board. Assets held by the board of the fund shall be invested in a similar manner.
646.21 History History: 1979 c. 109; 1983 a. 120.
subch. II of ch. 646 SUBCHAPTER II
CLAIMS PROCEDURES
646.31 646.31 Eligible claims.
646.31(1)(1)Conditions of eligibility. A claim is not eligible for payment from the fund unless it is an unpaid claim for a loss insured under the policy or annuity and all of the following conditions are met:
646.31(1)(a) (a) Issued by authorized insurer. The claim arises out of an insurance policy or annuity issued by an insurer which is in liquidation and which was authorized to do business in this state either at the time the policy or annuity was issued or when the insured event occurred.
646.31(1)(b) (b) Assessability of insurer. The claim arises out of business not exempt from assessment under s. 646.01 (1).
646.31(1)(c) (c) Contact with state. The claim is a member of one of the classes of claims under sub. (2).
646.31(1)(d) (d) Exceptions. The claim is not any of the following:
646.31(1)(d)1. 1. Based solely on a judgment.
646.31(1)(d)2. 2. Made for interest on any claim.
646.31(1)(d)3. 3. Made under s. 645.63 (2).
646.31(1)(d)4. 4. Subordinated under s. 645.90.
646.31(1)(d)5. 5. An indemnification recovered as a voidable preference under s. 645.54 (1) (c).
646.31(1)(d)6. 6. Made by an affiliate of an insurer in liquidation.
646.31(1)(d)7. 7. A retrospective premium rate adjustment.
646.31(1)(d)8. 8. Made for health care costs, as defined in s. 609.01 (1j), for which an enrolled participant, as defined in s. 609.01 (1d), or policyholder of a health maintenance organization insurer is not liable under ss. 609.91 to 609.935.
646.31(1)(d)9. 9. Made for health care costs, as defined in s. 609.01 (1j), for which an enrolled participant, as defined in s. 609.01 (1d), or policyholder of a health maintenance organization is not liable for any reason.
646.31(2) (2)Classes of claims to be paid. No claim may be paid under this chapter unless the claim is in one of the following classes:
646.31(2)(a) (a) Residents.
646.31(2)(a)1.1. The claim of a policyholder, including a ceding assessable domestic insurer which is organized under ch. 612 and a domestic insurer which is a bona fide policyholder of the insurer in liquidation, who at the time of the insured event or of the liquidation order was a resident of this state.
646.31(2)(a)2. 2. Except for a claim of a beneficiary, assignee or payee under a life or disability insurance policy or annuity contract, the claim of an insured, including a certificate holder, under a policy or annuity who at the time of the insured event or of the liquidation order was a resident of this state.
646.31(2)(b) (b) Certain nonresidents.
646.31(2)(b)1.1. Except with regard to claims under contracts that are held by residents of a state that does not provide substantially equivalent coverage with regard to contracts of residents of this state, the claim is made under a life or disability insurance policy or annuity contract subject to this section and issued by a domestic insurer, whether or not the claimant is a resident of this state.
646.31(2)(b)2. 2. The claim is made under a life or disability insurance policy or annuity contract subject to this section and issued by a domestic insurer if all of the following conditions are met:
646.31(2)(b)2.a. a. The claimant is a resident of another state that provides coverage similar to the coverage provided under this chapter but does not provide coverage for the claimant.
646.31(2)(b)2.b. b. The insurer never held a license or certificate of authority in the state in which the claimant resides.
646.31(2)(b)3. 3. The claim is made before January 1, 1990, under a life or disability insurance policy or annuity contract subject to this section and issued by a domestic insurer if all of the following conditions are met:
646.31(2)(b)3.a. a. The claimant was a resident of this state when the policy or contract was issued.
646.31(2)(b)3.b. b. The claimant is a resident of a state which does not provide coverage similar to the coverage provided under this chapter.
646.31(2)(c) (c) Owners of property interests. The claim of a person having an insurable interest in or related to property which was situated in this state at the time of the insured event.
646.31(2)(d) (d) Third party claimants. A claim under a liability or workers' compensation insurance policy, if:
646.31(2)(d)1. 1. Either the insured or the 3rd party claimant was a resident of this state at the time of the insured event;
646.31(2)(d)2. 2. The claim is for bodily or other personal injuries suffered in this state or by a person who suffered the injuries while a resident of this state; or
646.31(2)(d)3. 3. The claim is for damage to property situated in this state at the time the damage occurred.
646.31(2)(e) (e) Assignees. The claim of a direct or indirect resident assignee, other than an insurer, of a person who except for the assignment could have claimed under par. (a), (b), (c) or (d).
646.31(2)(f) (f) Beneficiaries, assignees and payees. Except for a claim of a nonresident certificate holder under a group policy or contract, a claim made under a life or disability insurance policy or annuity contract by a resident or nonresident beneficiary, assignee or payee of a person who fulfills all of the following criteria:
646.31(2)(f)1. 1. The person is a policyholder of, or a certificate holder under, the life or disability insurance policy or annuity contract.
646.31(2)(f)2. 2. The person is a resident of this state or could have made a claim under par. (b) 2.
646.31(3) (3)Deductible.
646.31(3)(a)(a) In this subsection, "health insurance policy" does not include a policy providing income continuation coverage or benefits for loss of time.
646.31(3)(am) (am) Except as provided in pars. (b) and (c), payment under this chapter is limited to the amount by which the claim exceeds $200. Claims may not be aggregated by assignment or otherwise for application of this deductible.
646.31(3)(b) (b) With regard to contracts subject to s. 646.35 (2) or (3) other than health insurance policies, in lieu of the deductible under par. (am), the board may impose a deductible not to exceed the lesser of 10% or $200 on any claim or other benefit payment if the board deems the imposition of this deductible more equitable or practical than that under par. (am).
646.31(3)(c) (c) A claim or other benefit payment under this chapter that is made under a health insurance policy may not be subject to the deductible under par. (am) or (b).
646.31(4) (4)Maximum claim.
646.31(4)(a)(a) Except in regard to worker's compensation insurance and except as provided in par. (b), the obligation of the fund on a single risk, loss or life may not exceed $300,000.
646.31(4)(b) (b) The fund is not obligated to pay a claimant an amount in excess of the loss obligation of the insurer in liquidation under the policy or coverage from which the claim arises.
646.31(5) (5)Punitive damages. No punitive damages may be paid out of the fund.
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