[Rev. 6/20/2022 8:21:10 AM]
[NAC-679B Revised Date: 5-22]
CHAPTER 679B - COMMISSIONER OF INSURANCE
GENERAL PROVISIONS
679B.011 Definitions.
679B.021 “Commissioner” defined.
679B.031 “Division” defined.
679B.033 Adoption by reference and availability of certain publications regarding conduct and report of examinations and evaluations of financial conditions; applicability; revision of publications after adoption; preparation of financial statements in accordance with appropriate publications.
679B.0335 Reasonable and proper expenses of examination.
679B.034 Confidentiality of records or other information obtained pursuant to NRS 679B.250.
679B.035 Conflicts of interest: Adoption of policy by licensed insurer domiciled in Nevada; filing of disclosure.
679B.036 Interpretation of “group organized for purposes other than the procurement of insurance.”
679B.0385 Interpretation of “unsuitable manner.”
679B.039 Interpretation of “unsuitable person.”
679B.0395 Fee for returned or dishonored check or other method of payment.
679B.0405 Use of prescribed form to obtain information related to credentials of provider of health care.
679B.0407 Use of log to record information concerning access by Division to computer assigned or loaned to officer, employee or contractor.
679B.0409 Transactions by electronic means.
INSURANCE RECOVERY ACCOUNT
679B.041 Definitions.
679B.043 “Account” defined.
679B.050 “Final judgment” defined.
679B.070 “Licensee” defined.
679B.078 Assessment of fee to maintain balance in Account: Payment upon issuance or renewal of license; failure to pay; administrative fine.
679B.080 Petition for payment from Account.
679B.090 Contents of petition; decision of court.
679B.100 Procedure for payment from Account.
679B.111 Repayment; effect of discharge of debt in bankruptcy.
679B.121 Payment of claims.
679B.131 Assignment of judgment.
679B.141 Waiver of rights.
679B.151 Disciplinary action; effect of repayment of obligations.
INVESTIGATION OF FRAUDULENT CLAIMS
679B.152 Release for public inspection of records or information related to investigation of fraudulent claim.
679B.154 Special Investigative Account: Notice of amount of assessment.
679B.157 Special Investigative Account: Payment of assessment; administrative fine; waiver of right to administrative hearing; willful violation.
PRACTICE BEFORE THE DIVISION
Hearings
679B.161 Applicability; deviation from provisions.
679B.170 Definitions.
679B.181 Interpretation of “unsuitable conduct.”
679B.190 Hearing calendar.
679B.195 Dismissal of action for want of prosecution.
679B.201 Dismissal of proceeding initiated by Division.
679B.211 Hearings: Person presiding; date; continuance.
679B.241 Pleadings: Filing.
679B.243 Pleadings: Requirements for format; signature; request for hearing.
679B.245 Pleadings: Amendment, correction or cure of omission.
679B.250 Pleadings: Service of copies to other parties or counsel; proof of service.
679B.260 Prehearing conference: Procedure to call; purpose.
679B.270 Prehearing conference: Effect of actions; failure of party or counsel to attend.
679B.280 Hearings: Subpoenas.
679B.311 Hearings: Appearances; notice of representation by counsel.
679B.313 Hearings: Requirements for attorney appearing as counsel; conduct.
679B.315 Hearings: Withdrawal of appearance of attorney of record.
679B.321 Hearings: Failure of certain parties to appear.
679B.331 Conferences at hearing.
679B.341 Hearings: Transcription.
679B.351 Hearings: Conduct required.
679B.353 Hearings: Misconduct of attorney.
679B.361 Hearings: Former representatives of Division.
679B.371 Hearings: Affidavits.
679B.381 Hearings: Documentary exhibits.
679B.390 Hearings: Official notice.
679B.400 Briefs.
679B.411 Hearings: Orders.
679B.413 Filing of answer to contest complaint or order to show cause.
679B.415 Hearings: Motions and responses to motions.
679B.421 Rehearing.
679B.440 Hearings: Review of decisions.
679B.451 Hearings to enhance public understanding of coverages offered and encourage competition.
679B.460 Interveners: Petitions for leave to intervene.
679B.470 Interveners: Filing of petitions.
679B.480 Interveners: Decision on petition.
Requests for Action
679B.482 Petition for adoption, filing, amendment or repeal of regulation: Filing and contents.
679B.484 Petition for adoption, filing, amendment or repeal of regulation: Prerequisites to consideration; notification of decision.
679B.486 Petition for declaratory order or advisory opinion: Filing and contents; limitation.
679B.488 Petition for declaratory order or advisory opinion: Prerequisites to consideration; notice of order or opinion.
679B.490 Oral advisory opinion.
COLLECTION OF INFORMATION ON TRANSACTIONS WITH PARENT CORPORATIONS, SUBSIDIARIES AND AFFILIATES
679B.501 Definitions.
679B.541 Payment of less than fair market value for services or products: Filing requirements.
679B.551 Payment of less than fair market value for services or products: Failure to comply with filing requirements.
COLLECTION, USE AND DISCLOSURE OF INFORMATION ON TRANSACTIONS OF INSURANCE
679B.560 Definitions.
679B.565 “Adverse underwriting decision” defined.
679B.570 “Affiliate” defined.
679B.575 “Applicant” defined.
679B.580 “Consumer report” defined.
679B.585 “Consumer reporting agency” defined.
679B.590 “Control” defined.
679B.595 “Declination of insurance coverage” defined.
679B.598 “Health insurance” defined.
679B.600 “Institutional source” defined.
679B.605 “Insurance institution” defined.
679B.611 “Insurance-support organization” defined.
679B.615 “Insurance transaction” defined.
679B.621 “Investigative consumer report” defined.
679B.625 “Medical care institution” defined.
679B.631 “Medical professional” defined.
679B.635 “Medical record information” defined.
679B.641 “Natural person” defined.
679B.650 “Personal information” defined.
679B.655 “Policyholder” defined.
679B.660 “Pretext interview” defined.
679B.665 “Privileged information” defined.
679B.670 “Termination of insurance coverage” defined.
679B.675 Applicability.
679B.680 Use of pretext interviews.
679B.685 Notice of practices for gathering information; retention and disclosure of certain information.
679B.690 Specification of questions for marketing or research.
679B.695 Contents of form to authorize disclosure.
679B.700 Preparation of investigative consumer report; personal interview.
679B.705 Access to recorded personal information.
679B.710 Correction, amendment or deletion of recorded personal information.
679B.715 Notification of reasons for adverse underwriting decision; summary of rights.
679B.720 Seeking information concerning previous adverse underwriting decision.
679B.725 Basis for adverse underwriting decision.
679B.730 Limitations upon and conditions of disclosure.
679B.735 Investigation by Commissioner.
679B.740 Hearings.
679B.745 Service of process on insurance-support organization outside of State.
679B.750 Penalties.
PROCESSING OF CLAIMS FOR PHARMACY BENEFITS
679B.775 Definitions.
679B.780 “Health care plan” defined.
679B.785 “Insured” defined.
679B.790 “Insurer” defined.
679B.795 Prohibited acts by insurer.
DISCLOSURE OF NONPUBLIC PERSONAL FINANCIAL INFORMATION
General Provisions
679B.800 Definitions.
679B.802 “Affiliate” defined.
679B.804 “Clear and conspicuous” defined.
679B.806 “Collect” defined.
679B.808 “Company” defined.
679B.810 “Consumer” defined.
679B.812 “Consumer reporting agency” defined.
679B.814 “Control” defined.
679B.816 “Customer” defined.
679B.818 “Customer relationship” defined.
679B.820 “Financial institution” defined.
679B.822 “Insurance product or service” defined.
679B.824 “Licensee” defined.
679B.826 “Nonaffiliated third party” defined.
679B.828 “Nonpublic personal financial information” defined.
679B.829 “Nonpublic personal health information” defined.
679B.8295 “Nonpublic personal information” defined.
679B.830 “Personally identifiable financial information” defined.
679B.832 “Publicly available information” defined.
679B.834 Scope.
679B.836 Applicability.
679B.838 Limitations on construction of provisions.
679B.840 Severability.
Programs for the Security of Customer Information
679B.841 Definitions.
679B.8412 “Customer information” defined.
679B.8413 “Customer information system” defined.
679B.8414 “Service provider” defined.
679B.8415 Licensee: Requirements for written program.
679B.8416 General requirements for design of program.
679B.8417 Factors considered by Commissioner in determining whether program is satisfactory.
Privacy and Opt-Out Notices
679B.842 Initial privacy notice to consumers required.
679B.844 Annual privacy notice to customers required; exception.
679B.846 Information to be included in privacy notices: General items; description of parties subject to exceptions; categories of information collected and disclosed; categories of affiliates and nonaffiliated third parties to whom information disclosed.
679B.848 Other information to be included in certain privacy notices; short form initial notice for noncustomers.
679B.850 Requirements for privacy notice on website.
679B.852 Sample clauses for use by licensees in complying with requirements for privacy notices.
679B.854 Circumstances under which licensee not subject to notice and opt-out requirements; compliance with requirements by surplus lines broker and surplus lines insurer.
679B.856 Form of opt-out notice to consumers; opt-out methods.
679B.858 Form of opt-out notice to joint consumers; opt-out methods.
679B.860 Revised privacy notices.
679B.862 Delivery of notices.
Limitations on Disclosure of Certain Financial Information
679B.864 Disclosure of information to nonaffiliated third parties.
679B.866 Redisclosure and reuse of information.
679B.868 Disclosure of policy number or similar form of access number or access code for policy or transaction account for marketing purposes.
Exceptions to Limitations on Disclosure of Certain Financial Information
679B.870 Exceptions to opt-out requirements for disclosure of information for service providers and joint marketing.
679B.872 Exceptions to notice and opt-out requirements for disclosure of information for processing and servicing transactions.
679B.874 Other exceptions to notice and opt-out requirements for disclosure of information.
Miscellaneous Provisions
679B.876 Discrimination prohibited.
679B.878 Failure to comply with requirements regarding notices and disclosures.
GENERAL PROVISIONS
NAC 679B.011 Definitions. As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 679B.021 and 679B.031 have the meanings ascribed to them in those sections.
(Supplied in codification)
NAC 679B.021 “Commissioner” defined. (NRS 679B.130) “Commissioner” means the Commissioner of Insurance.
[Comm’r of Insurance, M-1 § 4, eff. 5-13-72]—(Substituted in revision for NAC 679B.020)
NAC 679B.031 “Division” defined. (NRS 679B.130) “Division” means the Division of Insurance of the Department of Business and Industry.
[Comm’r of Insurance, M-1 § 5, eff. 5-13-72]—(NAC A 5-27-92)
NAC 679B.033 Adoption by reference and availability of certain publications regarding conduct and report of examinations and evaluations of financial conditions; applicability; revision of publications after adoption; preparation of financial statements in accordance with appropriate publications. (NRS 679B.130)
1. The following publications of the National Association of Insurance Commissioners are hereby adopted by reference and may be obtained by mail from the National Association of Insurance Commissioners, Publications Department, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106-2197, or by ordering via telephone at (816) 783-8300, or on the Internet at www.naic.org/account_manager.htm, or by electronic mail at [email protected], at the respective prices indicated:
(a) The Financial Condition Examiners Handbook, which may be obtained at the domestic price of $295 and the international price of $325 for a paper copy or a copy on USB.
(b) The Market Regulation Handbook, which may be obtained at the domestic price of $525 and the international price of $580 for a paper copy or a copy on USB.
(c) The Market Regulation Handbook - Examination Standards Summary, which may be obtained free of charge.
(d) The Accounting Practices and Procedures Manual, which may be obtained at the domestic price of $500 and the international price of $550 for a paper copy, or at the domestic price of $465 and the international price of $510 for an electronic copy.
(e) The Annual and Quarterly Statement Blanks for Life and Accident and Health, which may be obtained at the domestic price of $225 and the international price of $250.
(f) The Annual and Quarterly Statement Blanks for Property and Casualty, which may be obtained at the domestic price of $225 and the international price of $250.
(g) The Annual and Quarterly Statement Blanks for Health, which may be obtained at the domestic price of $225 and the international price of $250.
(h) The Annual and Quarterly Statement Blanks for Fraternal, which may be obtained at the domestic price of $225 and the international price of $250.
(i) The Annual and Quarterly Statement Blanks for Title, which may be obtained at the domestic price of $225 and the international price of $250.
(j) The Annual and Quarterly Statement Instructions for Life and Accident and Health, which may be obtained at the domestic price of $250 and the international price of $275. Except as otherwise provided in paragraph (l), these instructions must be used by an insurer that, under its certificate of authority, transacts health insurance or life insurance, as those terms are defined in NRS 681A.030 and 681A.040, respectively.
(k) The Annual and Quarterly Statement Instructions for Property and Casualty, which may be obtained at the domestic price of $250 and the international price of $275. These instructions must be used by an insurer that, under its certificate of authority, transacts casualty insurance or property insurance, as those terms are defined in NRS 681A.020 and 681A.060, respectively.
(l) The Annual and Quarterly Statement Instructions for Health, which may be obtained at the domestic price of $250 and the international price of $275. These instructions must be used by an insurer whose certificate of authority is issued in accordance with NRS 695B.110, 695C.090, 695D.110 or 695F.100.
(m) The Annual and Quarterly Statement Instructions for Fraternal, which may be obtained at the domestic price of $250 and the international price of $275. These instructions must be used by an insurer that, under its certificate of authority, transacts insurance for a fraternal benefit society, as that term is defined in NRS 695A.010.
(n) The Annual and Quarterly Statement Instructions for Title, which may be obtained at the domestic price of $250 and the international price of $275. These instructions must be used by an insurer that, under its certificate of authority, transacts title insurance, as that term is defined in NRS 681A.080.
2. The publications listed in subsection 1 apply to the:
(a) Conduct and report of an examination made pursuant to NRS 679B.230 to 679B.300, inclusive, 695C.310 and 695D.270; and
(b) Evaluation of the financial condition of an insurer or organization based on an examination or its annual statement. As used in this paragraph, “organization” includes:
(1) A health maintenance organization, as that term is defined in NRS 695C.030; and
(2) An organization for dental care, as that term is defined in NRS 695D.060.
3. If any publication listed in subsection 1 is revised, the Commissioner will review the revision to determine its suitability for this State. If the Commissioner determines that the revision is not suitable for this State, he or she will give notice within 30 days after the effective date of the revision. If the Commissioner does not give notice within 30 days, the revision becomes part of the publication adopted by reference pursuant to subsection 1. If a revision becomes part of a publication pursuant to this subsection and a person objects to and is aggrieved by the revision, that person may request a hearing before the Commissioner pursuant to NRS 679B.310 to 679B.370, inclusive.
4. The Market Regulation Handbook will be used in the examination of the records of an administrator.
5. All persons, including, without limitation, insurers and health maintenance organizations, required to file financial statements with the Commissioner shall prepare those statements in accordance with the appropriate publications adopted by reference in this section.
(Added to NAC by Comm’r of Insurance, eff. 12-3-84; A 1-22-86; 12-9-91; 3-20-96; R028-02, 5-31-2002; R247-03 & R249-03, 11-12-2004; R089-17, 5-16-2018)
NAC 679B.0335 Reasonable and proper expenses of examination. (NRS 679B.130, 679B.290) Reasonable and proper expenses, as described in NRS 679B.290, may include, but are not limited to:
1. For a financial examiner or market conduct examiner, a daily salary as defined in the Financial Condition Examiners Handbook or the Market Regulation Handbook, as applicable, published by the National Association of Insurance Commissioners, which has been adopted by reference in NAC 679B.033.
2. For expert assistants, a daily salary based upon the rate established in the contract approved by the State Board of Examiners.
3. The maximum per diem rate for the location of the examination as set forth in the Federal Travel Regulation System of the General Services Administration, 41 C.F.R. Chapter 301. A current schedule of the maximum per diem rates as set forth in the Federal Travel Regulation System of the General Services Administration, 41 C.F.R. Chapter 301, is available at no cost on the Internet at http://www.gsa.gov/perdiem.
4. Expenses for transportation, including, but not limited to, the cost of airfare, rail fare, taxicab fare and automobile rental and the reimbursement of any personal automobile expenses necessary to reach the location of the examination. The calculation of expenses for transportation may include expenses for transportation incurred by virtue of the length of time necessary to complete the examination.
5. Upon approval of the Commissioner, miscellaneous expenses incurred by the examiner and assistants while performing an examination. Miscellaneous expenses may include, but are not limited to, expenses for telephone calls, facsimile transmissions and postal charges relating to the examination.
6. An administrative charge, expressed as a percentage of the daily salary of the examiner or assistant, as provided in subsections 1 and 2 and as provided in the Division budget approved by the Nevada Legislature.
(Added to NAC by Comm’r of Insurance, eff. 5-23-96; A by R028-02, 5-31-2002; R171-08, 2-11-2009; R089-17, 5-16-2018)
NAC 679B.034 Confidentiality of records or other information obtained pursuant to NRS 679B.250. (NRS 679B.130, 679B.190)
1. Except as otherwise provided in this section or required by NRS 679B.280:
(a) Any records or other information obtained pursuant to NRS 679B.250 shall be deemed to be obtained by the Commissioner or examiner upon the express condition that they remain confidential.
(b) The Commissioner will classify those records and that other information as confidential during the period:
(1) Before completion of the examination unless the Commissioner determines that the interests of the public, or of the policyholders or shareholders of the person being examined, will be served by allowing public inspection of the records and other information at that time.
(2) After completion of the examination unless:
(I) The Commissioner takes disciplinary action based upon the results of the examination;
(II) The person who was being examined submits to the Commissioner a written request to release the records and other information for public inspection; or
(III) A law enforcement agency requests release of the records and other information for public inspection.
2. No records or other information may be released for public inspection pursuant to subparagraph (2) of paragraph (b) of subsection 1 except upon the written order of the Commissioner.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94; A by R028-12, 9-14-2012)
NAC 679B.035 Conflicts of interest: Adoption of policy by licensed insurer domiciled in Nevada; filing of disclosure. (NRS 679B.130)
1. A licensed insurer that is domiciled in this State shall adopt a conflict of interest policy for its attorneys-in-fact, trustees, managers, officers and directors. For any person governed by the policy, the policy must include:
(a) A requirement that the person annually disclose any outside commitment, personal or otherwise, that would conflict with his or her duty to further the interests of the insurer;
(b) A clear expression that the person has a duty of care to protect the interests of the insurer above anyone other than the insurer; and
(c) A requirement that the person provide a complete annual disclosure of each material relationship that he or she has with the insurer or a consultant or service provider to the insurer.
2. Each attorney-in-fact, trustee, manager, officer or director of a licensed insurer that is domiciled in this State shall annually file a disclosure of his or her conflicts of interest with the board of directors or subscribers’ advisory committee of the insurer.
3. Nothing in this section shall be construed to prevent an attorney-in-fact, trustee, manager, officer or director of a licensed insurer that is domiciled in this State from being a director or officer of more than one insurance company or insurer.
4. As used in this section:
(a) “Material relationship” means any relationship in which an attorney-in-fact, trustee, manager, officer or director of a licensed insurer that is domiciled in this State, any member of such a person’s immediate family or any business with which such a person is affiliated receives compensation or payment of any other item of value from the insurer or a consultant or service provider, as applicable, to the insurer of an amount greater than $15,000 within any 12-month period.
(b) “Service provider” means any manager, auditor, accountant, actuary, investment adviser, attorney, managing general underwriter, managing general agent, attorney-in-fact or any other person responsible for underwriting, the determination of rates, the collection of premiums, adjusting and settling claims or the preparation of financial statements.
(Added to NAC by Comm’r of Insurance by R078-16, eff. 12-21-2016)
NAC 679B.036 Interpretation of “group organized for purposes other than the procurement of insurance.” (NRS 679B.130, 680A.070, 685B.030) The Commissioner of Insurance will interpret the phrase “group organized for purposes other than the procurement of insurance,” as used in NRS 680A.070 and 685B.030, to include the following:
1. A single employer providing life or health insurance benefits to his or her eligible employees, officers, directors or proprietors and their dependents.
2. A multiple employer group or trust holding a policy on behalf of multiple employers providing life or health insurance benefits to eligible employees, officers, directors or proprietors and their dependents if the policy is issued pursuant to a collective bargaining agreement.
3. A political subdivision or an agency of a political subdivision providing life or health insurance benefits to current or retired employees or officers.
4. An association of persons engaged in a business or profession subject to certification or licensure by the State of Nevada or the Federal Government so long as membership in the association is limited to such persons.
5. An association or trust which acts as the policyholder for one or more associations or groups of otherwise unaffiliated persons providing life or health insurance benefits if:
(a) The association or trust was formed without the involvement of any insurance company, administrator, agent, broker or representative thereof;
(b) Solicitation for membership or participation in the association or affiliated group is made by a person who is not in any way affiliated with or compensated by an insurance company, administrator, agent, broker or solicitor;
(c) The membership solicitation material refers only to the availability of participation in insurance programs;
(d) The association has a constitution and bylaws which require regular meetings at least annually to further the purposes of the members and provide members with the privileges of voting and actively participating in the activities of the association;
(e) The association conducts substantial educational, charitable, civic or advisory activities on behalf of its members; and
(f) No person employed by, representing, affiliated with, compensated by or otherwise related to an insurance company, administrator, agent or broker is any way involved in the management or membership solicitation activities of the association.
(Added to NAC by Comm’r of Insurance, 11-1-84, eff. 7-1-85; A 10-12-88)
NAC 679B.0385 Interpretation of “unsuitable manner.” (NRS 679B.125, 679B.130) As used in NRS 679B.125 and 680A.200, “unsuitable manner” means conducting insurance business in a manner which:
1. Results in a violation of any statute or regulation of this State relating to insurance;
2. Results in an intentional violation of any other statute or regulation of this State; or
3. Causes injury to the general public,
Ê with such frequency as to indicate a general business practice.
(Added to NAC by Comm’r of Insurance, eff. 1-10-97)
NAC 679B.039 Interpretation of “unsuitable person.” (NRS 679B.125, 679B.130) As used in NRS 679B.125, “unsuitable person” means a person who is:
1. Determined by the Commissioner to be untrustworthy or dishonest;
2. Determined by the Commissioner to have violated intentionally any statute or regulation relating to insurance; or
3. Convicted in any jurisdiction of a crime which involves theft, fraud, dishonesty or moral turpitude.
(Added to NAC by Comm’r of Insurance, eff. 1-10-97)
NAC 679B.0395 Fee for returned or dishonored check or other method of payment. (NRS 679B.130, 679B.228) In accordance with NRS 353C.115 and NAC 353C.400, the Division shall charge any person whose check or other method of payment is returned to the Division or otherwise dishonored because the person had insufficient money or credit with the drawee or financial institution to pay the check or other method of payment or because the person stopped payment on the check or other method of payment a fee of $25 or such other amount as may subsequently be required by NRS 353C.115 and NAC 353C.400.
(Added to NAC by Comm’r of Insurance by R082-98, eff. 1-27-2000; A by R068-07, 1-30-2008)
NAC 679B.0405 Use of prescribed form to obtain information related to credentials of provider of health care. (NRS 679B.130)
1. Each insurer, carrier, society, corporation, health maintenance organization and managed care organization shall use the Nevada Division of Insurance (NDOI) Form 901 prescribed by the Commissioner of Insurance pursuant to NRS 629.095 when obtaining any information related to the credentials of a provider of health care.
2. If an insurer, carrier, society, corporation, health maintenance organization or managed care organization needs information to satisfy a requirement newly imposed by the Federal Government, the State or one of its agencies, or a body that accredits hospitals, medical facilities or health care plans and that information is not addressed in NDOI Form 901, the insurer, carrier, society, corporation, health maintenance organization or managed care organization:
(a) Shall notify the Commissioner of the additional information that must be requested in NDOI Form 901 to satisfy the requirement; and
(b) May use an addendum to NDOI Form 901 to obtain the information necessary to satisfy the requirement until NDOI Form 901 has been revised to include a request for such information.
3. As used in this section, the words and terms defined in NRS 629.095 have the meanings ascribed to them in that section.
(Added to NAC by Comm’r of Insurance by R026-04, eff. 7-1-2004)
NAC 679B.0407 Use of log to record information concerning access by Division to computer assigned or loaned to officer, employee or contractor. (NRS 281.195)
1. The Division shall, in a log maintained by the Division, record the information concerning access by the Division to a computer of the Division that has been assigned or loaned to an officer, employee or a contractor for his or her exclusive or routine use in carrying out the duties of his or her position that is required pursuant to subsection 4 of NRS 281.195.
2. As used in this section, “access” has the meaning ascribed to it in NRS 281.195.
(Added to NAC by Comm’r of Insurance by R160-05, eff. 12-29-2005)
NAC 679B.0409 Transactions by electronic means. (NRS 679B.130, 679B.136)
1. Except as otherwise provided in NRS 691D.330 and NAC 691D.300, an insurer shall not conduct a transaction by electronic means, including, without limitation, transactions involving claims, electronic signatures, electronic payments or other insurance-related records in electronic form, unless each person who is a party to the transaction agrees to conduct the transaction by electronic means.
2. If a person who is a party to a transaction agrees to conduct the transaction by electronic means, the insurer shall document the agreement, including, without limitation:
(a) The name of the person agreeing to conduct the transaction by electronic means;
(b) The type of transaction that the person has agreed to conduct by electronic means; and
(c) The date and time of the agreement.
3. A person who agrees to conduct a transaction by electronic means may limit the types of transactions which he or she agrees to conduct by electronic means.
4. If an insurer is required to retain a record, the insurer may retain the record electronically if the insurer is able accurately to reproduce the record upon the request of a person who is entitled to a copy of the record, including, without limitation, an insured, a claimant and the Commissioner.
5. Except as otherwise provided in NRS 691D.330 and NAC 691D.300, an insurer shall not provide a notice which terminates a policy of insurance, including, without limitation, a notice of cancellation or nonrenewal, solely by electronic means.
(Added to NAC by Comm’r of Insurance by R035-12, eff. 11-1-2012)
INSURANCE RECOVERY ACCOUNT
NAC 679B.041 Definitions. (NRS 679B.130, 679B.305) As used in NAC 679B.041 to 679B.151, inclusive, unless the context otherwise requires, the words and terms defined in NAC 679B.043 to 679B.070, inclusive, have the meanings ascribed to them in those sections.
(Supplied in codification; A by Comm’r of Insurance by R152-99, 1-28-2000; R001-16, 6-28-2016)
NAC 679B.043 “Account” defined. (NRS 679B.305) “Account” means the Insurance Recovery Account created pursuant to NRS 679B.305.
(Added to NAC by Comm’r of Insurance by R152-99, eff. 1-28-2000)
NAC 679B.050 “Final judgment” defined. (NRS 679B.305) “Final judgment” means a judgment of a court of competent jurisdiction based upon the merits of the case:
1. Which finds fraud, intentional misrepresentation, embezzlement or deceit on the part of a licensee in connection with a transaction for which the licensee was licensed; and
2. Upon which the time for appeal has elapsed without the filing of an appeal or upon which a decision has been rendered on appeal and no further recourse is available.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000)
NAC 679B.070 “Licensee” defined. (NRS 679B.130, 679B.305) “Licensee” means a person who possesses a license issued by the Division under chapter 683A, 684A, 685A or 692A of NRS.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A 5-27-92; R001-16, 6-28-2016)
NAC 679B.078 Assessment of fee to maintain balance in Account: Payment upon issuance or renewal of license; failure to pay; administrative fine. (NRS 679B.130, 679B.305)
1. If the Commissioner assesses the fee authorized pursuant to NRS 679B.305, the fee will be assessed at the time of the issuance or renewal of a license issued by the Division under chapter 683A, 684A, 685A or 692A of NRS.
2. If a person fails to pay the fee assessed pursuant to subsection 1, his or her license will not be issued or renewed, as applicable.
3. If a person who wishes to renew his or her license pays the fee assessed pursuant to subsection 1 after the date the fee is due, the person is subject to an administrative fine equal to the amount of the fee.
(Added to NAC by Comm’r of Insurance by R001-16, eff. 6-28-2016)
NAC 679B.080 Petition for payment from Account. (NRS 679B.305)
1. If a person obtains a final judgment, he or she may file a verified petition with the Commissioner for an order directing payment out of the Account in an amount equal to the unpaid compensatory damages awarded in the judgment.
2. The amount claimed in the petition may not include court costs or interest on the compensatory damages.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000)
NAC 679B.090 Contents of petition; decision of court. (NRS 679B.305)
1. A petition for payment must contain copies of the documents of the court which show, to the satisfaction of the Commissioner, the grounds for the final judgment. The petition must also:
(a) Show that a special verdict or a general verdict with written interrogatories was rendered in accordance with Rule 49 of Nevada Rules of Civil Procedure;
(b) Show that findings of fact and conclusions of law were made pursuant to Rule 52 of Nevada Rules of Civil Procedure; or
(c) If the court does not make findings of fact and conclusions of law, provide proof that the final judgment or evidence included in the petition demonstrates that the ground for the final judgment was the commission by the licensee of any of the acts described in subsection 2.
2. Except as otherwise provided in this subsection, the decision of the court must include a specific finding by the court that the licensee perpetrated fraud, intentional misrepresentation, embezzlement or deceit on the petitioner in connection with a transaction for which the licensee was licensed. If the decision of the court does not include a specific finding, sufficient evidence that the licensee committed any of the acts set forth in this subsection must be presented to the Commissioner. The Commissioner will accept copies of verdicts and findings from federal and state courts including findings made pursuant to Title 11 of the United States Code relating to the discharge of the bankrupt, if he or she determines that there is a final judgment which includes a specific finding of fraud, intentional misrepresentation, embezzlement or deceit on the part of the licensee.
3. The petitioner must verify under oath or affirm in his or her petition that:
(a) The petitioner is not the spouse of the licensee or the personal representative of that spouse;
(b) The petitioner has complied with all of the requirements of NRS 679B.305 and NAC 679B.041 to 679B.151, inclusive;
(c) The petitioner has obtained a final judgment, stating the amount of the judgment and the amount owing on it at the time of the petition;
(d) A writ of execution has been issued upon the final judgment and no assets of the licensee liable to execution could be found, or the amount realized on the sale of assets was insufficient to satisfy the final judgment, stating the amount realized and the balance due;
(e) Searches and inquiries have been made to ascertain whether the licensee possesses real or personal property or other assets which may be sold or applied in satisfaction of the judgment and must include a specific description of those searches and inquiries; and
(f) The petition has been filed not more than 12 months after the termination of all proceedings, including reviews and appeals, in connection with the final judgment.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000)
NAC 679B.100 Procedure for payment from Account. (NRS 679B.305)
1. Within 30 days after the filing of the petition, the Commissioner may make investigations to verify the truthfulness of the matters asserted in the petition and determine whether the searches and inquiries for real and personal property have been reasonable. The investigation will include making contact with the licensee, if possible.
2. Any licensee whose actions have resulted in the filing of a petition against the Account may request a hearing to contest the allegations of the petition within 15 days after he or she has been served. The request must be accompanied by a statement specifying the reasons that recovery should not be allowed against the Account.
3. Upon the completion of the investigations, determinations and the hearing, if held, the Commissioner will enter an order which directs payment in a specific amount or denies a recovery. The order will set forth the reasons for the allowance or denial of a recovery against the Account.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000)
NAC 679B.111 Repayment; effect of discharge of debt in bankruptcy. (NRS 679B.130, 679B.305)
1. The Commissioner may treat any payment from the Account in settlement of a claim or toward satisfaction of a final judgment against a licensee as sufficient ground for the revocation or suspension of his or her license or for any other appropriate discipline. No license may be reinstated until the licensee has repaid the amount paid from the Account on his or her behalf, plus interest at the prevailing rate for a judgment rendered in any court of this State. The interest must be calculated from the date the payment was made from the Account.
2. A discharge in bankruptcy of the debt created by the final judgment does not relieve a person from the penalties provided in NAC 679B.041 to 679B.151, inclusive.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000; R001-16, 6-28-2016)
NAC 679B.121 Payment of claims. (NRS 679B.305)
1. Whenever claims are approved in any fiscal year against the Account which total more than the maximum liability of $5,000 for the acts of one licensee, the $5,000 must be distributed among the claimants in the proportion that their respective claims bear to the total of all claims approved.
2. All petitions for payment out of the Account must be filed on or before May 15 of the fiscal year for which the petitioner is seeking relief. Except as provided in subsection 3, all money will be distributed on June 30 of each fiscal year.
3. If, on June 30, the money deposited in the Account and allotted for the satisfaction of claims is insufficient to satisfy any approved claim or portion thereof, the Commissioner will pay the claims or portions of the claims in the order in which they were filed. The Commissioner will satisfy the unpaid claims when sufficient money has been deposited in the Account.
4. The Commissioner will not pay interest on any approved claim or portion of a claim.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000)
NAC 679B.131 Assignment of judgment. (NRS 679B.305) If the Commissioner pays any sum from the Account to a petitioner, the petitioner must assign his or her interest in the final judgment to the Commissioner to the extent of the payment made to the petitioner. The Commissioner will deposit any amount recovered on the judgment in the Account. The assignment must be in a form acceptable to the Commissioner.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R152-99, 1-28-2000)
NAC 679B.141 Waiver of rights. (NRS 679B.130, 679B.305) Failure of a person or licensee to comply with any of the provisions of NRS 679B.305 or NAC 679B.041 to 679B.151, inclusive, constitutes a waiver of any rights under NAC 679B.041 to 679B.151, inclusive.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A by R001-16, 6-28-2016)
NAC 679B.151 Disciplinary action; effect of repayment of obligations. (NRS 679B.130, 679B.305) The provisions of NAC 679B.041 to 679B.151, inclusive, do not limit the authority of the Commissioner to take disciplinary action against a licensee for a violation of any of the provisions of chapters 683A, 684A, 685A and 692A of NRS, NAC 679B.041 to 679B.151, inclusive, or other regulations of the Division, nor does the repayment in full of any obligations to the Account by a licensee nullify or modify the effect of any disciplinary proceeding brought pursuant to the provisions of NAC 679B.041 to 679B.151, inclusive, or the statutory provisions of title 57 of NRS.
(Added to NAC by Comm’r of Insurance, eff. 3-18-82; A 5-27-92; R152-99, 1-28-2000; R001-16, 6-28-2016)
INVESTIGATION OF FRAUDULENT CLAIMS
NAC 679B.152 Release for public inspection of records or information related to investigation of fraudulent claim. (NRS 679B.130, 679B.190) For the purposes of paragraph (a) of subsection 3 of NRS 679B.190, the release for public inspection of any records or information related to the investigation of a fraudulent claim:
1. Before completion of the investigation shall be deemed harmful to the investigation or person being investigated unless the Commissioner determines that the interests of the public will be served by allowing the release for public inspection at that time.
2. After completion of the investigation shall be deemed harmful to the investigation or person who was being investigated unless:
(a) The person who was being investigated submits to the Commissioner a written request to allow the release for public inspection; or
(b) A law enforcement agency requests the release for public inspection.
Ê No records or information may be released for public inspection pursuant to this subsection except upon the written order of the Commissioner.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.154 Special Investigative Account: Notice of amount of assessment. (NRS 679B.130, 679B.700) The Commissioner will provide to each insurer a notice of the amount of the assessment for the Special Investigative Account that is owed pursuant to subsection 4 of NRS 679B.700 on or before June 1 of each year.
(Added to NAC by Comm’r of Insurance, eff. 10-30-85; A 5-27-92; 3-30-94; R082-98, 1-27-2000; R001-16, 6-28-2016)
NAC 679B.157 Special Investigative Account: Payment of assessment; administrative fine; waiver of right to administrative hearing; willful violation. (NRS 679B.130, 679B.700)
1. Each insurer who holds a certificate of authority in this State on January 1 of a calendar year shall pay the assessment for the investigation of fraudulent claims on or before July 15 of that year.
2. Each such insurer who fails to pay this assessment or pays it late is subject to an administrative fine in an amount equal to the assessment. This fine is assessed by the Division upon notice to the company accompanied by a bill for the assessment and fine. Payment of the bill waives any right to an administrative hearing on the matter, and the bill must so state.
3. An insurer who pays the assessment late in 2 consecutive years, or fails to pay it for 2 consecutive years, shall be deemed to have willfully violated this section and the provisions of NRS 679B.700. The late payment or nonpayment reflects on the competency of the management of the company.
(Added to NAC by Comm’r of Insurance, eff. 10-30-85; A 5-27-92; 3-30-94; R001-16, 6-28-2016)
PRACTICE BEFORE THE DIVISION
Hearings
NAC 679B.161 Applicability; deviation from provisions. (NRS 679B.130, 679B.310)
1. Except as otherwise provided in this section, the provisions of chapter 233B of NRS, NRS 679B.310 to 679B.370, inclusive, and NAC 679B.161 to 679B.480, inclusive, govern practice before the Division. To the extent that any action before the Division is not covered by those provisions, the Division may follow any applicable rule in the Nevada Rules of Civil Procedure.
2. If good cause appears and if stipulated by all parties, the hearing officer may deviate from the provisions of NAC 679B.161 to 679B.480, inclusive.
[Comm’r of Insurance, M-1 §§ 1-3, eff. 5-13-72]—(NAC A 11-21-88; 12-15-94; R110-04, 9-16-2004)
NAC 679B.170 Definitions. (NRS 679B.130, 679B.310) As used in NAC 679B.161 to 679B.480, inclusive, unless the context otherwise requires:
1. “Hearing officer” means the Commissioner or another person designated by the Commissioner to conduct a hearing.
2. “Intervener” means a person, other than an original party to a proceeding, whose pecuniary interests may be directly and immediately affected by the proceeding and who has secured an order from a hearing officer granting leave to intervene.
3. “Party” means the Division, any other original party to the proceeding and any intervener.
4. “Petitioner” means a person who applies for a hearing before the Division.
5. “Respondent” means a person who is required to respond in an administrative proceeding commenced by the Division or the Commissioner.
6. “Staff” means persons employed by or working with the Division.
[Comm’r of Insurance, M-1 §§ 4-13, eff. 5-13-72]—(NAC A 11-21-88; 1-27-92; 5-27-92; 12-15-94)
NAC 679B.181 Interpretation of “unsuitable conduct.” (NRS 679B.130, 679B.310) As used in NRS 679B.310, the Commissioner will interpret “unsuitable conduct” to include any act or omission which:
1. Results in a felony conviction of an insurer or an employee of the insurer in any jurisdiction in the United States if the insurer knows of the conviction and does not disclose it to the Commissioner before the license or certificate of authority is issued to the insurer;
2. Results in a felony conviction of an insurer or an employee of the insurer in any jurisdiction in the United States after the license or certificate of authority is issued to the insurer; or
3. Is an intentional violation of a statute or regulation of this State relating to insurance that has occurred with such frequency as to indicate a general business practice of an insurer or an employee of an insurer.
(Added to NAC by Comm’r of Insurance, eff. 1-10-97)
NAC 679B.190 Hearing calendar. (NRS 679B.130, 679B.310) The Commissioner will maintain a hearing calendar and make assignments for hearings from it. A copy of the hearing calendar will be maintained at each office of the Division.
[Comm’r of Insurance, M-1 § 17, eff. 5-13-72]—(NAC A 5-27-92)
NAC 679B.195 Dismissal of action for want of prosecution. (NRS 679B.130, 679B.310)
1. The Commissioner may, in his or her discretion and for good cause, upon his or her own motion or upon the motion of any party, dismiss any action before the Division for want of prosecution after providing proper notice to all parties.
2. The Commissioner will dismiss any action for want of prosecution if, after a period of 1 year from the date the action was filed, the party requesting the hearing has, without good cause, caused the hearing to be delayed unreasonably.
(Added to NAC by Comm’r of Insurance by R110-04, eff. 9-16-2004)
NAC 679B.201 Dismissal of proceeding initiated by Division. (NRS 679B.130, 679B.310) The Division may dismiss a proceeding it has initiated through the filing of a complaint and service of an order to show cause, without prejudice to the initiation of another proceeding based upon the same set of facts, during the period:
1. After it has filed the complaint and served the order to show cause; and
2. Before a hearing is conducted on the matter.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.211 Hearings: Person presiding; date; continuance. (NRS 679B.130, 679B.310, 679B.320, 679B.330)
1. Hearings will be held before the Commissioner or a hearing officer designated by the Commissioner pursuant to NRS 679B.330.
2. A hearing will be set for a date which is earlier than the date set forth in the notice of the hearing if all parties so agree in writing.
3. Upon the written request of any party, the hearing officer may:
(a) Continue the hearing until a later date; or
(b) Upon good cause shown, continue the hearing for the submission of further proof of any matter.
[Comm’r of Insurance, M-1 § 31, eff. 5-13-72]—(NAC A 11-21-88)
NAC 679B.241 Pleadings: Filing. (NRS 679B.130, 679B.310)
1. All pleadings, including complaints, petitions, answers, briefs, motions, responses to motions, affidavits and applications, must be addressed to and filed with the Commissioner. Pleadings shall be deemed to be officially filed with the Commissioner when a true copy is received by the Division.
2. The hearing officer may require a party to file two or more legible copies of a pleading.
3. The acceptance of a document for filing shall not be deemed to constitute:
(a) A determination that the document complies with all applicable statutes and regulations; or
(b) A waiver of any applicable statutes or regulations.
[Comm’r of Insurance, M-1 § 14, eff. 5-13-72]—(NAC A 5-27-92; 12-15-94)
NAC 679B.243 Pleadings: Requirements for format; signature; request for hearing. (NRS 679B.130, 679B.310)
1. Pleadings must:
(a) Be properly titled.
(b) Be signed in ink by the party or his or her counsel.
(c) Include the name and address of each party and the name, address and telephone number of the party’s counsel, if any.
(d) Except for an initial pleading, clearly identify the proceeding by title and number.
(e) Contain a clear and concise statement of the matters relied upon as a basis for the action or relief requested.
(f) Be typewritten, printed or reproduced on good quality white paper, which is approximately 8 1/2 by 11 inches in size. Any exhibit or appendix accompanying a pleading must be folded to that size. Information must be presented on only one side of the paper and must be double spaced, except for footnotes or quotations which are indented. All of the copies of a pleading and of any exhibit or appendix accompanying a pleading must be clear and permanently legible.
2. Regardless of any error in the designation of a pleading, the hearing officer shall accord the pleading its true status in the proceeding in which it is filed.
3. A signature on the pleading shall be deemed to constitute a representation that:
(a) The person signing the pleading has read the pleading;
(b) To the best of the person’s knowledge, there are good grounds to support the pleading;
(c) The information in the pleading is true to the best of his or her knowledge and belief; and
(d) The pleading is not filed solely to delay the proceeding.
4. If a person filing a pleading desires a hearing on the matter, a request for a hearing must be stated in the pleading.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.245 Pleadings: Amendment, correction or cure of omission. (NRS 679B.130, 679B.310)
1. If no substantial rights of the parties will be prejudiced, the hearing officer shall allow a pleading to be amended or corrected or any omission in a pleading to be cured.
2. The hearing officer shall liberally construe the pleadings and disregard any defects which do not affect the substantial rights of any party.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.250 Pleadings: Service of copies to other parties or counsel; proof of service. (NRS 679B.130, 679B.310)
1. After the commencement of a proceeding, a party who files a pleading shall serve a copy of the pleading to every other party. If a party is represented by counsel, service of the pleading must be to that counsel.
2. Except as otherwise required by specific statute or regulation, all pleadings and other documents required to be served may be served in person or by mail. If service is by mail, service is complete when a true copy of the document, properly addressed and stamped, is deposited in the United States mail.
3. An acknowledgment of service or the following certificate must appear on all documents required to be served:
I hereby certify that I have this day served the foregoing document upon all parties of record in this proceeding (by delivering a copy thereof in person to ................) (by mailing a copy thereof, properly addressed, with postage prepaid, to ................)
Dated at ..................., this .........(day) of ...................(month) of .........(year)
.......................................................................
Signature
[Comm’r of Insurance, M-1 § 15, eff. 5-13-72]—(NAC A 12-15-94)
NAC 679B.260 Prehearing conference: Procedure to call; purpose. (NRS 679B.130, 679B.310) The hearing officer may, upon his or her own motion or upon the motion of any party, by giving 7 days’ prior written notice of the time and place to all parties, hold a prehearing conference for the purpose of formulating or simplifying the issues, obtaining admissions of fact and documents which will avoid unnecessary proof, arranging for the exchange of proposed exhibits or prepared expert testimony, limiting the number of witnesses and considering other matters which may permit rapid orderly conduct and disposition of the proceedings or settlements thereof.
[Comm’r of Insurance, M-1 § 18, eff. 5-13-72]—(Substituted in revision for NAC 679B.210)
NAC 679B.270 Prehearing conference: Effect of actions; failure of party or counsel to attend. (NRS 679B.130, 679B.310)
1. Any action taken at a prehearing conference and the agreements, admissions or stipulations made by the parties at the conference:
(a) Must be made a part of the record; and
(b) Controls the course of subsequent proceedings unless modified at the hearing by the hearing officer.
2. Unless otherwise ordered by the hearing officer for good cause shown, the failure of a party or his or her counsel to attend a prehearing conference shall be deemed a waiver of any objection to any action taken at the conference and any agreements, admissions or stipulations made by the parties at the conference.
[Comm’r of Insurance, M-1 § 19, eff. 5-13-72]—(NAC A 11-21-88; 12-15-94)
NAC 679B.280 Hearings: Subpoenas. (NRS 679B.130, 679B.310, 679B.340)
1. Petitioners or respondents who desire to subpoena witnesses must apply in writing to the hearing officer, if one has been designated, or to the Commissioner if a hearing officer has not been designated, and set forth the reasons why the subpoena is requested.
2. The hearing officer, if one has been designated, or the Commissioner if a hearing officer has not been designated, may issue a subpoena duces tecum after a written request which specifies as clearly as possible, the books, papers, accounts or other documents desired. Within 3 working days after the receipt of the application, the hearing officer or Commissioner shall grant the request and issue the subpoena or deny the request. The hearing officer or Commissioner may, for good cause shown, issue a subpoena duces tecum upon an oral motion.
3. A petitioner or respondent who applies for a subpoena or subpoena duces tecum pursuant to this section must serve a copy of the application to all parties.
4. All costs incident to the execution of a subpoena or subpoena duces tecum issued at the request of the petitioner or respondent must be borne by the petitioner or respondent, and the hearing officer may demand payment of those costs before issuing the subpoenas.
[Comm’r of Insurance, M-1 § 23, eff. 5-13-72]—(NAC A 11-21-88; 12-15-94)
NAC 679B.311 Hearings: Appearances; notice of representation by counsel. (NRS 679B.130, 679B.310)
1. A party, if other than a natural person, may appear:
(a) If a partnership, by a partner.
(b) If a corporation, by an officer or other authorized representative or regular employee.
(c) If a municipal corporation, by an authorized officer, agent or employee.
(d) If an unincorporated association, by an authorized representative, officer or employee.
2. A party who wishes to be represented by counsel shall notify the Division in writing of the name, address and telephone number of his or her counsel not later than 5 days before the hearing.
[Comm’r of Insurance, M-1 § 27, eff. 5-13-72]—(NAC A 11-21-88; 5-27-92)
NAC 679B.313 Hearings: Requirements for attorney appearing as counsel; conduct. (NRS 679B.130, 679B.310)
1. An attorney appearing as counsel in any proceeding before the Division must be admitted to practice and in good standing before the highest court of any state. Except as otherwise ordered by the hearing officer, an attorney who is not admitted and entitled to practice before the Supreme Court of Nevada must be associated with an attorney so admitted and entitled to practice.
2. An attorney’s appearance as counsel in a proceeding shall be deemed to constitute his or her representation that the attorney will conduct himself or herself in accordance with the requirements of NAC 679B.351.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.315 Hearings: Withdrawal of appearance of attorney of record. (NRS 679B.130, 679B.310)
1. No attorney of record in a contested proceeding before the Division may withdraw his or her appearance in the proceeding except by order of the hearing officer. To obtain such an order, an attorney must:
(a) File with the hearing officer a motion to withdraw, which sets forth the reasons for his or her request; and
(b) Serve the motion to withdraw to all parties, including the party the attorney represents.
2. If the hearing officer grants such a motion, the substitute attorney shall file and serve, as provided in NAC 679B.241 and 679B.250, respectively, a notice of substitution of counsel.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.321 Hearings: Failure of certain parties to appear. (NRS 679B.130, 679B.310)
1. If a party requesting a hearing fails to appear at the time and place set for the hearing, the hearing officer may, if satisfied that the party has received appropriate notice of the hearing pursuant to NRS 679B.320:
(a) Proceed with the hearing without the party;
(b) Dismiss the proceeding with or without prejudice; or
(c) Recess the hearing to a time set by the hearing officer to enable the party to attend.
2. If a party who has been ordered to appear at a hearing by written order or by notice of a hearing fails to appear at the time and place set for the hearing, the hearing officer may, if satisfied that the party has received appropriate notice of the hearing pursuant to NRS 679B.320:
(a) Proceed with the hearing without the party; or
(b) Recess the hearing to a time set by the hearing officer to enable the party to attend.
[Comm’r of Insurance, M-1 § 32, eff. 5-13-72]—(NAC A by R110-04, 9-16-2004; R080-07, 12-4-2007)
NAC 679B.331 Conferences at hearing. (NRS 679B.130, 679B.310) In any proceeding the hearing officer may call all parties together for a conference before the taking of testimony, or may recess the hearing for a conference for the purpose of securing just, speedy and economical determination of all issues. The hearing officer shall state on the record the results of the conference.
[Comm’r of Insurance, M-1 § 20, eff. 5-13-72]—(Substituted in revision for NAC 679B.340)
NAC 679B.341 Hearings: Transcription. (NRS 679B.130, 679B.310, 679B.330) Any party wishing to receive a transcribed copy of the record pursuant to NRS 679B.330 must request it in writing at least 5 days before the date set for the prehearing, hearing or rehearing.
[Comm’r of Insurance, M-1 § 22, eff. 5-13-72]—(NAC A 11-21-88)
NAC 679B.351 Hearings: Conduct required. (NRS 679B.130, 679B.310)
1. All parties to a hearing, their counsel and spectators shall conduct themselves in a respectful manner.
2. Attorneys representing parties in a proceeding shall conduct themselves in accordance with the rules of professional conduct adopted by the Supreme Court of Nevada.
3. If the Commissioner has reason to believe that a party or his or her counsel has violated NRS 239.300, 239.310 or 239.330 when inspecting or copying any public records of the Division, the Commissioner will refer the matter, with all relevant information, to the Attorney General.
[Comm’r of Insurance, M-1 § 28, eff. 5-13-72]—(NAC A 12-15-94)
NAC 679B.353 Hearings: Misconduct of attorney. (NRS 679B.130, 679B.310)
1. If counsel for a party engages in any contumacious conduct at a hearing and repeatedly disregards admonishments by the hearing officer to cease that conduct, the hearing officer may:
(a) Order the exclusion of the counsel who engaged in that conduct from any further appearances in the proceeding; and
(b) Continue the hearing for a reasonable period, not to exceed 30 days, to enable the party whose counsel has been excluded to obtain substitute counsel.
2. The Commissioner may report any misconduct of an attorney occurring during a proceeding before the Division to the State Bar of Nevada or the state bar of any other state, commonwealth, territory or district where the attorney is admitted to practice.
3. For the purposes of this section, “misconduct of an attorney” includes:
(a) Failing to appear timely before the hearing officer for prehearing conferences, hearings on motions or other hearings.
(b) Presenting to the hearing officer unnecessary motions, unwarranted opposition to motions or unwarranted objections to the testimony of witnesses or the admissibility of evidence.
(c) Examining or cross-examining witnesses with repetitive questions.
(d) Unreasonably and vexatiously increasing the time and cost of a proceeding.
(e) Failing to comply with any order of the hearing officer.
(f) Violating NRS 239.300, 239.310 or 239.330 when inspecting or copying any public records of the Division.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.361 Hearings: Former representatives of Division. (NRS 679B.130, 679B.310)
1. No former employee of the Division or member of the Attorney General’s staff may appear in a representative capacity on behalf of other parties in a proceeding in which he or she previously took an active part as a representative of the Division except with the written permission of the Commissioner.
2. No former employee of the Division may appear as an expert witness on behalf of other parties in a proceeding in which he or she previously took an active part in investigation or preparation as a representative of the Division except with the written permission of the Commissioner.
[Comm’r of Insurance, M-1 § 29, eff. 5-13-72]—(NAC A 11-21-88; 5-27-92)
NAC 679B.371 Hearings: Affidavits. (NRS 679B.130, 679B.310)
1. The affidavit of any person may be admitted in evidence if all parties consent to its admission.
2. All parties intending to offer an affidavit must serve the Division and all other parties with a copy of the affidavit. Except as otherwise provided in this subsection, the service must be made not less than 12 calendar days before the hearing and is effective upon mailing. If mailed, 3 days will be added to the period within which service must be made. The mailing of an affidavit to the address of record of a party which is on file with the Division shall be deemed proper service.
3. Failure to object to the use of an affidavit shall be deemed to be consent to its use. Except as otherwise provided in this subsection, an objection to the use of a proposed affidavit must be served upon each party not less than 6 calendar days before the hearing. Service is effective upon mailing. If service is mailed, 3 days will be added to the period within which service must be made. No party may object to the use of an affidavit which has no relevancy to the party.
4. Extensions of the deadlines prescribed in this section may be granted by the hearing officer if good cause is shown.
[Comm’r of Insurance, M-1 § 35, eff. 5-13-72]—(NAC A 11-21-88; 5-27-92)
NAC 679B.381 Hearings: Documentary exhibits. (NRS 679B.130, 679B.310)
1. Before a documentary exhibit may be introduced at a hearing, a copy of the exhibit must be furnished to each party.
2. In a proceeding involving detailed or voluminous exhibits, the hearing officer may require each party to file, and to serve to each other party, a copy of the exhibits within a specified time before the hearing. An amendment to an exhibit may be made after the exhibit has been filed, if the amendment does not prejudice the rights of any party or corrects a clerical or mathematical error.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.390 Hearings: Official notice. (NRS 679B.130, 679B.310) The hearing officer may take official notice of:
1. Rules, regulations, official reports, decisions and orders of any regulatory agency of the State of Nevada or any court of law.
2. Contents of decisions, orders, certificates, licenses and records maintained or issued by the Division.
[Comm’r of Insurance, M-1 § 37, eff. 5-13-72]—(NAC A 11-21-88; 5-27-92)
NAC 679B.400 Briefs. (NRS 679B.130, 679B.310) In any hearing, the hearing officer may order briefs filed within a period which expires not less than 20 days after the date of the order. Two copies of each brief must be filed, together with an acknowledgment of or an affidavit showing service on all other parties of record.
[Comm’r of Insurance, M-1 § 39, eff. 5-13-72]—(NAC A 11-21-88; 12-15-94)
NAC 679B.411 Hearings: Orders. (NRS 679B.130, 679B.310)
1. The hearing officer shall file a copy of his or her order with the Division. The copy must be kept available for public inspection.
2. If the hearing officer is not the Commissioner, the Commissioner will indicate on the order his or her concurrence or disagreement with the order of the hearing officer.
[Comm’r of Insurance, M-1 § 41, eff. 5-13-72]—(NAC A 11-21-88; 5-27-92)
NAC 679B.413 Filing of answer to contest complaint or order to show cause. (NRS 679B.130, 679B.310)
1. A party who desires to contest a complaint or order to show cause may file an answer.
2. An answer must:
(a) Be in writing;
(b) Be filed within 20 days after receipt of service of the complaint or order to show cause, unless otherwise ordered by the hearing officer;
(c) Specifically admit or deny each material allegation in the complaint or order to show cause; and
(d) State any new matter constituting a defense. Matters alleged by way of an affirmative defense must be separately stated and numbered.
3. If an amendment or correction to a pleading is filed:
(a) Before the filing of an answer, the time within which to answer must be computed from the date of service of the amendment or correction, unless otherwise ordered by the hearing officer.
(b) After the filing of an answer, another answer need not be filed.
4. The failure to file an answer or to raise a jurisdictional defect does not waive the right to raise a jurisdictional defect at any time.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.415 Hearings: Motions and responses to motions. (NRS 679B.130, 679B.310)
1. A request for an order by the hearing officer, except for an order to permit intervention or an order to show cause, concerning any matter that has not been finally decided by the hearing officer must be styled a “motion.”
2. Any party against whom a motion is directed, including any person who filed a petition for intervention before the motion was filed and served, may file a response to the motion.
3. Except as otherwise provided in subsection 4:
(a) A motion or response to a motion must:
(1) Be made in writing; and
(2) Include citations of any authorities upon which it relies.
(b) A motion must be filed and served, as provided in NAC 679B.241 and 679B.250, respectively, no later than 10 days before the date set for the hearing on the motion, unless otherwise ordered by the hearing officer.
(c) A response to a motion must be filed and served, as provided in NAC 679B.241 and 679B.250, respectively, no later than 7 days after receipt of service of the motion, unless otherwise ordered by the hearing officer.
4. A written or oral motion or response to a motion, if timely, may be made during a hearing.
5. The hearing officer:
(a) May order the parties to file affidavits in support of or in contravention of a motion or response to a motion.
(b) May direct that any oral motion or oral response to a motion made at a hearing be reduced to writing.
(c) May, upon his or her own motion or upon the motion of any party, by giving all parties at least 7 days’ prior written notice of the time and place of the hearing, hold a hearing for the purpose of ruling on a motion.
(d) May, if the hearing officer’s ruling would not constitute a final determination of a proceeding, rule on a motion made at a hearing at any time before his or her final decision and order.
(e) Shall, if his or her ruling would involve a final determination of a proceeding, including a motion to dismiss, rule on a motion when the hearing officer delivers his or her final decision and order, unless the hearing officer determines that an expedited ruling would be in the public interest.
(Added to NAC by Comm’r of Insurance, eff. 12-15-94)
NAC 679B.421 Rehearing. (NRS 679B.130, 679B.310)
1. The hearing officer may, upon motion made within 10 days after service of a decision and order and before a petition for judicial review has been filed, order a rehearing upon terms and conditions which he or she deems just and proper.
2. A motion for rehearing may not be granted except upon a showing that there is additional evidence which is material and necessary and reasonably calculated to change the decision, and that there was sufficient reason for failure to present such evidence at the hearing.
3. The motion must be supported by an affidavit of the moving party or his or her counsel showing with particularity the materiality and necessity of the additional evidence and the reason why it was not introduced at the hearing. Upon rehearing, the hearing officer may modify his or her decision and order as the additional evidence warrants.
[Comm’r of Insurance, M-1 § 47, eff. 5-13-72]—(Substituted in revision for NAC 679B.530)
NAC 679B.440 Hearings: Review of decisions. (NRS 679B.130, 679B.310)
1. Any person seeking review, modification or reversal of any decision made by the hearing officer has the burden of proof in any hearing ordered for the review, modification or reversal. Evidence may be received in any manner ordered by the hearing officer, but will ordinarily be received from the parties in the following order:
(a) The petitioner.
(b) The staff.
(c) Interveners.
(d) The petitioner, if he or she has a rebuttal.
2. In proceedings initiated or commenced by the Division, evidence will ordinarily be received in the following order:
(a) The staff.
(b) The respondent who, if he or she does not testify in his or her own behalf, may be called and examined as if under cross-examination.
(c) Interveners.
(d) The staff, if there is a rebuttal.
(e) The respondent, if he or she has a rebuttal.
[Comm’r of Insurance, M-1 § 34, eff. 5-13-72]—(NAC A 11-21-88; 5-27-92)
NAC 679B.451 Hearings to enhance public understanding of coverages offered and encourage competition. (NRS 679B.130, 679B.310)
1. If the Commissioner holds a public hearing to carry out the provisions of NRS 679B.150, the following rules of practice apply:
(a) The Commissioner or his or her designated hearing officer may receive any oral, written or documentary evidence concerning the subjects described in the notice of the hearing.
(b) No person may be designated as a party or an intervener.
(c) The Commissioner will give notice of such a hearing to:
(1) Any insurer or rate service organization whose name appears on the notice; and
(2) Members of the public by posting a copy of the notice at the Division’s offices and the location of meeting.
Ê The notice will be given pursuant to the requirements set forth in subsection 3 of NRS 679B.140.
2. The Commissioner may use any evidence or testimony presented at such a hearing in his or her consideration of the factors listed in NRS 686B.050 and 686B.060 for any filings made by an insurer or a rate service organization pursuant to NRS 686B.070 or NAC 686B.700 to 686B.765, inclusive.
(Added to NAC by Comm’r of Insurance, eff. 1-27-92)
NAC 679B.460 Interveners: Petitions for leave to intervene. (NRS 679B.130, 679B.310, 679B.330)
1. A person who wishes to intervene in a hearing pursuant to subsection 4 of NRS 679B.330 must secure an order from the hearing officer granting leave to intervene before he or she will be allowed to participate in the hearing.
2. A petition for leave to intervene must be in writing and must clearly identify the proceeding in which the petitioner seeks to intervene.
3. The petition must set forth the name and address of the petitioner and contain a clear and concise statement of the direct and immediate interest of the petitioner in the proceeding, state the manner in which the petitioner will be affected by the proceeding and outline the matters relied upon by the petitioner as a basis for his or her request to intervene.
4. If affirmative relief is sought, the petition must contain a clear and concise statement of relief sought and the basis thereof, together with a statement as to the nature and quantity of evidence the petitioner will present if the petition is granted.
[Comm’r of Insurance, M-1 § 44, eff. 5-13-72]—(NAC A 11-21-88)
NAC 679B.470 Interveners: Filing of petitions. (NRS 679B.130, 679B.310, 679B.330) A petition to intervene and proof of service of copies thereof on all other parties of record must be filed not less than 2 days before commencement of the hearing. Thereafter, the petition must state a substantial reason for the delay or it will not be considered.
[Comm’r of Insurance, M-1 § 45, eff. 5-13-72]—(Substituted in revision for NAC 679B.630)
NAC 679B.480 Interveners: Decision on petition. (NRS 679B.130, 679B.310, 679B.330)
1. If a petition to intervene shows that the petitioner has a direct and immediate pecuniary interest in the subject of the proceeding or any part thereof and does not unduly broaden the issues, the hearing officer may grant him or her leave to intervene or otherwise appear in the proceeding with respect to the matters set out in the petition, subject to such reasonable conditions as the hearing officer prescribes.
2. If it appears during the course of a proceeding that an intervener has no direct or immediate pecuniary interest in the proceeding and that the public interest does not require his or her participation, the hearing officer may dismiss the intervener from the proceeding.
[Comm’r of Insurance, M-1 § 46, eff. 5-13-72]—(Substituted in revision for NAC 679B.640)
Requests for Action
NAC 679B.482 Petition for adoption, filing, amendment or repeal of regulation: Filing and contents. (NRS 679B.130)
1. A petition which requests the adoption, filing, amendment or repeal of a regulation of the Division must be filed with the Commissioner.
2. The petition must include:
(a) The name and address of the petitioner;
(b) A clear and concise statement of the regulation to be adopted, filed, amended or repealed;
(c) If the petition requests the adoption of a regulation, the full text of the proposed regulation;
(d) The reason for the adoption, filing, amendment or repeal of the regulation; and
(e) The statutory authority for the adoption, filing, amendment or repeal of the regulation.
(Added to NAC by Comm’r of Insurance, eff. 5-27-92; A 12-15-94)
NAC 679B.484 Petition for adoption, filing, amendment or repeal of regulation: Prerequisites to consideration; notification of decision. (NRS 679B.130)
1. The Commissioner will not review a petition which requests the adoption, filing, amendment or repeal of a regulation unless the petition contains the information required by NAC 679B.482.
2. The Commissioner will notify the petitioner in writing of his or her decision within 30 days after the petition is filed.
(Added to NAC by Comm’r of Insurance, eff. 5-27-92; A by R082-12, 11-1-2012)
NAC 679B.486 Petition for declaratory order or advisory opinion: Filing and contents; limitation. (NRS 679B.130)
1. A petition which requests the Commissioner to issue a declaratory order or advisory opinion must be filed with the Commissioner.
2. The petition must include:
(a) The name and address of the petitioner;
(b) The reason for requesting the order or opinion; and
(c) A clear and concise statement of the question to be decided by the Commissioner and the relief sought by the petitioner.
3. The Commissioner will not review a petition filed by an interested person which requests him or her to issue a declaratory order or an advisory opinion concerning a question or matter that is an issue in an administrative, civil or criminal proceeding in which the interested person is a party.
(Added to NAC by Comm’r of Insurance, eff. 5-27-92)
NAC 679B.488 Petition for declaratory order or advisory opinion: Prerequisites to consideration; notice of order or opinion. (NRS 679B.130)
1. The Commissioner will not review a petition which requests him or her to issue a declaratory order or advisory opinion unless the petition contains the information required by NAC 679B.486.
2. The Commissioner will mail a copy of the order or opinion to the petitioner within 60 days after the petition is filed.
(Added to NAC by Comm’r of Insurance, eff. 5-27-92; A by R082-12, 11-1-2012)
NAC 679B.490 Oral advisory opinion. (NRS 679B.130) The Commissioner will not issue an oral advisory opinion or respond over the telephone to a request for an advisory opinion. An oral response or a response given over the telephone by a member of the staff of the Division is not a decision or an advisory opinion of the Commissioner or Division.
(Added to NAC by Comm’r of Insurance, eff. 5-27-92)
COLLECTION OF INFORMATION ON TRANSACTIONS WITH PARENT CORPORATIONS, SUBSIDIARIES AND AFFILIATES
NAC 679B.501 Definitions. (NRS 679B.130, 680A.320) As used in NAC 679B.541 and 679B.551, unless the context otherwise requires:
1. “Health insurer” means any insurance company or nonprofit medical service corporation which:
(a) Issues a policy of health insurance or evidence of coverage; or
(b) Provides benefits of health insurance for residents of this State.
Ê The term includes a health maintenance organization as defined in NRS 695C.030.
2. “Inpatient” means a person who has been admitted to a hospital and charged by that hospital for at least 1 day of room and board.
3. “Policy of health insurance” means a policy offered by a health insurer which provides for hospitalization, surgery or other major medical benefits. The term does not include a policy offering any benefits for accidents only, loss of income because of disability, dental services, vision services, payments for daily expenses while in the hospital or services for prescription drugs.
(Added to NAC by Comm’r of Insurance, eff. 1-20-88)
NAC 679B.541 Payment of less than fair market value for services or products: Filing requirements. (NRS 679B.130, 680A.320) Each health insurer which pays less than fair market value for services or products in a transaction which is subject to the provisions of paragraph (i) of subsection 2 of NRS 680A.320 shall file with the Commissioner, on or before March 31st of each year, the:
1. Certification that the reduced payment has been reflected in the form of reduced premiums; and
2. Documentation supporting the certification,
Ê which are required by paragraph (i) of subsection 2 of NRS 680A.320.
(Added to NAC by Comm’r of Insurance, eff. 1-20-88; A 10-29-92)
NAC 679B.551 Payment of less than fair market value for services or products: Failure to comply with filing requirements. (NRS 679B.130, 680A.320) In addition to any other disciplinary action which may be taken by the Commissioner, the Commissioner will fine a health insurer which pays less than fair market value for services or products in a transaction which is subject to the provisions of paragraph (i) of subsection 2 of NRS 680A.320 and fails to or incompletely files the:
1. Certification that the reduced payment has been reflected in the form of reduced premiums; and
2. Documentation supporting the certification,
Ê which are required by NAC 679B.541, $100 per day until the filing is made or completed, but not to exceed a total of $2,000.
(Added to NAC by Comm’r of Insurance, eff. 1-20-88; A 10-29-92)
COLLECTION, USE AND DISCLOSURE OF INFORMATION ON TRANSACTIONS OF INSURANCE
NAC 679B.560 Definitions. (NRS 679B.130) As used in NAC 679B.560 to 679B.750, inclusive, unless the context otherwise requires, the words and terms defined in NAC 679B.565 to 679B.670, inclusive, have the meanings ascribed to them in those sections.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89; A 2-3-97)
NAC 679B.565 “Adverse underwriting decision” defined. (NRS 679B.130)
1. “Adverse underwriting decision” means any of the following actions involving insurance transactions with individually underwritten insurance coverage:
(a) A declination of insurance coverage.
(b) A termination of insurance coverage.
(c) Failure by an agent to apply for insurance coverage with a specific insurance institution which the agent represents and which was requested by an applicant.
(d) For property or casualty insurance coverage:
(1) Placement by an insurance institution or agent of an insured person with a residual market mechanism, an unauthorized insurer as described in chapter 685B of NRS or an insurance institution that specializes in substandard risks; or
(2) Charging a higher rate on the basis of information which differs from information obtained from the applicant or policyholder.
(e) An offer to insure at higher than standard rates for life, health or disability insurance coverage.
2. The following actions are not considered to be adverse underwriting decisions:
(a) The termination of an individual policy form on a class or statewide basis.
(b) A declination of insurance coverage solely because the coverage is not available on a class or statewide basis.
(c) The rescission of a policy.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.570 “Affiliate” defined. (NRS 679B.130) “Affiliate” means a person who controls or is controlled by one or more intermediaries either directly or indirectly, alone or together with another person.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.575 “Applicant” defined. (NRS 679B.130) “Applicant” means any person who wishes to contract for individually underwritten insurance coverage.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.580 “Consumer report” defined. (NRS 679B.130) “Consumer report” means any communication of information bearing on a natural person’s credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living which is used or expected to be used in connection with an insurance transaction.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.585 “Consumer reporting agency” defined. (NRS 679B.130) “Consumer reporting agency” means any person who regularly engages for a monetary fee in the practice of assembling, preparing and furnishing consumer reports for others by obtaining information primarily from sources other than insurance institutions.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.590 “Control” defined. (NRS 679B.130) “Control” means the direct or indirect ability to influence the management and policies of a person, whether through ownership of voting securities or a contract. The term does not include influence resulting from an official position or corporate office held by the person or from a commercial contract for goods or nonmanagement services.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.595 “Declination of insurance coverage” defined. (NRS 679B.130) “Declination of insurance coverage” means a denial of requested insurance coverage, in whole or in part, by an insurance institution or agent.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.598 “Health insurance” defined. (NRS 679B.130) “Health insurance” includes the coverage provided by a prepaid limited health service organization.
(Added to NAC by Comm’r of Insurance, eff. 2-3-97)
NAC 679B.600 “Institutional source” defined. (NRS 679B.130) “Institutional source” means any person or governmental entity that provides information about a natural person to an agent, insurance institution or insurance-support organization, other than:
1. An agent;
2. The natural person who is the subject of the information; or
3. A natural person acting in a personal capacity rather than in a business or professional capacity.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.605 “Insurance institution” defined. (NRS 679B.130) “Insurance institution” means any person engaged in the business of insurance as governed by title 57 of NRS. The term does not include agents or insurance-support organizations.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.611 “Insurance-support organization” defined. (NRS 679B.130) “Insurance-support organization” means any person who regularly engages in the practice of assembling or collecting information about natural persons for the primary purpose of providing the information to an insurance institution or agent for insurance transactions, including:
1. The furnishing of consumer reports or investigative consumer reports to an insurance institution or agent for use in connection with an insurance transaction; or
2. The collection of personal information from insurance institutions, agents or other insurance-support organizations to detect or prevent fraud, material misrepresentation or material nondisclosure in connection with insurance underwriting or insurance claim activity.
Ê The term does not include agents, governmental institutions, insurance institutions, medical care institutions and medical professionals.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.615 “Insurance transaction” defined. (NRS 679B.130) “Insurance transaction” means any transaction involving insurance primarily for personal, family or household needs or any group health policy that involves:
1. The determination of a natural person’s eligibility for insurance coverage, a benefit or a payment; or
2. The servicing of an insurance application, policy, contract or certificate.
Ê The term does not include insurance transactions made for business or professional needs.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.621 “Investigative consumer report” defined. (NRS 679B.130) “Investigative consumer report” means a report in which information about a natural person’s character, general reputation, personal characteristics or mode of living is obtained through personal interviews with the natural person’s neighbors, friends, associates, acquaintances or others who may have relevant information.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.625 “Medical care institution” defined. (NRS 679B.130) “Medical care institution” means any facility or institution licensed to provide health care services to natural persons.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.631 “Medical professional” defined. (NRS 679B.130) “Medical professional” means any person licensed or certified to provide health care services to natural persons.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.635 “Medical record information” defined. (NRS 679B.130) “Medical record information” means personal information which:
1. Relates to a natural person’s physical or mental condition, medical history or medical treatment; and
2. Is obtained from a medical professional, medical care institution, the natural person, or from the natural person’s spouse, parent or legal guardian.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.641 “Natural person” defined. (NRS 679B.130) “Natural person” means any natural person who:
1. In the case of property or casualty insurance, is a past, present or proposed named insured or certificate holder;
2. In the case of life, health or disability insurance, is a past, present or proposed principal insured or certificate holder;
3. Is a past, present or proposed policy owner;
4. Is a past or present applicant;
5. Is a past or present claimant; or
6. Held, holds or proposes to hold insurance coverage under an insurance policy or certificate subject to NAC 679B.560 to 679B.750, inclusive.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.650 “Personal information” defined. (NRS 679B.130)
1. “Personal information” means any identifiable piece of information gathered in connection with an insurance transaction from which judgments can be made about a natural person’s character, habits, avocations, finances, occupations, general reputation, credit, health or any other personal characteristics including, without limitation, his or her name, address and medical record information.
2. The term does not include:
(a) Privileged information; or
(b) Nonpublic personal financial information, as that term is defined in NAC 679B.828.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89; A by R130-01, 12-17-2002)
NAC 679B.655 “Policyholder” defined. (NRS 679B.130) “Policyholder” means any person who in the case of:
1. Individual property or casualty insurance, is a present named insured;
2. Individual life, health or disability insurance, is a present policy owner; or
3. Group insurance which is individually underwritten, is a present certificate holder in the group insurance plan.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.660 “Pretext interview” defined. (NRS 679B.130) “Pretext interview” means an interview whereby a person, in an attempt to obtain information about a natural person:
1. Pretends to be someone he or she is not;
2. Pretends to represent a person he or she is not in fact representing;
3. Misrepresents the true purpose of the interview; or
4. Refuses to identify himself or herself upon request.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.665 “Privileged information” defined. (NRS 679B.130) “Privileged information” means any identifiable piece of information that relates to and is collected in connection with or in reasonable anticipation of a claim for insurance benefits or a civil or criminal proceeding involving a natural person. Privileged information will be considered personal information if it is disclosed in violation of NAC 679B.730.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.670 “Termination of insurance coverage” defined. (NRS 679B.130) “Termination of insurance coverage” means a cancellation or nonrenewal of an insurance policy, in whole or in part, for any reason other than the failure to pay a premium as required by the policy.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.675 Applicability. (NRS 679B.130)
1. Except as otherwise provided in this section and NAC 679B.800 to 679B.878, inclusive, NAC 679B.560 to 679B.750, inclusive, apply to insurance institutions, agents or insurance support organizations which:
(a) In the case of life, health and disability insurance:
(1) Collect, receive or maintain information in connection with insurance transactions involving natural persons who are residents of this State; or
(2) Engage in insurance transactions with applicants, natural persons or policyholders who are residents of this State; or
(b) In the case of property or casualty insurance involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State:
(1) Collect, receive or maintain information in connection with insurance transactions; or
(2) Engage in insurance transactions.
2. Except as otherwise provided in this section and NAC 679B.800 to 679B.878, inclusive, the rights granted by NAC 679B.560 to 679B.750, inclusive, extend to:
(a) In the case of life, health or disability insurance, the following residents of this State:
(1) Natural persons who are the subject of information collected, received or maintained in connection with insurance transactions; and
(2) Applicants, natural persons or policyholders who engage in or seek to engage in insurance transactions; and
(b) In the case of property or casualty insurance:
(1) Natural persons who are the subject of information collected, received or maintained in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State; and
(2) Applicants, natural persons or policyholders who engage in or seek to engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this State.
3. For the purposes of this section, a person shall be deemed a resident of this State if the person’s last known mailing address, as shown in the records of the insurance institution, agent or insurance-support organization, is located in this State.
4. Notwithstanding subsections 1 and 2, NAC 679B.560 to 679B.750, inclusive, do not apply to:
(a) Information collected from the public records of a governmental authority and maintained by an insurance institution or its representatives for the purpose of insuring the title to real property located in this State; or
(b) Nonpublic personal financial information, as that term is defined in NAC 679B.828.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89; A by R130-01, 12-17-2002)
NAC 679B.680 Use of pretext interviews. (NRS 679B.130)
1. Except as otherwise provided in subsection 2, no insurance institution, agent or insurance-support organization may use or authorize the use of pretext interviews to obtain information in connection with an insurance transaction.
2. A pretext interview may be undertaken to obtain information from a person or institution that does not have a generally or statutorily recognized privileged relationship with the natural person about whom the information relates for the purpose of investigating a claim where, based upon scientific information available for review by the Commissioner, there is a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure in connection with the claim.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.685 Notice of practices for gathering information; retention and disclosure of certain information. (NRS 679B.130)
1. An insurance institution or agent shall provide a notice explaining its practices for gathering information to all applicants and policyholders in connection with insurance transactions pursuant to the following standards:
(a) In the case of an application for insurance, the notice must be provided no later than:
(1) The date on which the insurance policy or certificate is delivered when personal information is collected only from the applicant or from public records; or
(2) The commencement of collecting personal information from a source other than the applicant or public records.
(b) In the case of the renewal of a policy, the notice must be provided no later than the renewal date of the policy, except that no notice is required if:
(1) Personal information is collected only from the policyholder or from public records; or
(2) A notice meeting the requirements of this section has been provided to the policyholder within the previous 24 months.
(c) In the case of the reinstatement of a policy or change in insurance benefits, the notice must be provided no later than the time a request for reinstatement or a change in insurance benefits is received by the insurance institution, except that no notice is required if personal information is collected only from the policyholder or from public records.
2. The notice required by subsection 1 must be in writing and state:
(a) Whether personal information may be collected from persons other than the natural person or natural persons proposed for coverage.
(b) The types of personal information that may be collected and the types of sources and investigative techniques that may be used to collect the information.
(c) The types of disclosures identified in subsections 2 to 6, inclusive, 9, 11, 12 and 14 of NAC 679B.730 and the circumstances under which those disclosures may be made without first obtaining authorization. Only circumstances which occur frequently enough to indicate a general business practice may be described.
(d) A description of the rights established under NAC 679B.705 and 679B.710 and the manner in which those rights may be exercised.
3. Information obtained from a report prepared by an insurance-support organization may be retained by the insurance-support organization and disclosed to other persons.
4. In lieu of the notice required by subsection 1, the insurance institution or agent may provide an abbreviated notice informing the applicant or policyholder that:
(a) Personal information may be collected from persons other than the natural person or natural persons proposed for coverage;
(b) The information as well as other personal or privileged information subsequently collected by the insurance institution or agent may in certain circumstances be disclosed to third parties without authorization;
(c) A right of access and correction exists with respect to all personal information collected; and
(d) The notice prescribed in subsection 2 will be furnished to the applicant or policyholder upon request.
5. The obligations imposed by this section upon an insurance institution or agent may be satisfied by another insurance institution or agent authorized to act on its behalf.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.690 Specification of questions for marketing or research. (NRS 679B.130) An insurance institution or agent shall specify which questions of those directed toward a natural person in connection with an insurance transaction are designed to obtain information solely for marketing or research purposes.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.695 Contents of form to authorize disclosure. (NRS 679B.130) No insurance institution, agent or insurance-support organization may use as its disclosure authorization form for use in connection with an insurance transaction a form or statement which authorizes the disclosure of personal or privileged information about a natural person to the insurance institution, agent or insurance-support organization unless the form or statement:
1. Is written in plain language;
2. Is dated;
3. Specifies who may disclose information about the natural person;
4. Specifies the nature of the information authorized to be disclosed;
5. Names the insurance institution or agent;
6. Identifies by generic reference representatives of the insurance institution to whom the natural person is authorizing information to be disclosed;
7. Specifies the purposes for which the information is collected;
8. Specifies the length of time the authorization will remain valid, which must be no longer than:
(a) In the case of authorizations signed to collect information in connection with an application for an insurance policy, the reinstatement of a policy or a request for change in policy benefits:
(1) Thirty months from the date the authorization is signed if the application or request involves life, health or disability insurance; or
(2) One year from the date the authorization is signed if the application or request involves property or casualty insurance; or
(b) In the case of authorizations signed to collect information in connection with a claim for benefits under an insurance policy:
(1) The term of coverage of the policy if the claim is for a health insurance benefit; or
(2) The duration of the claim if the claim is not for a health insurance benefit; and
9. Advises the natural person or a person authorized to act on behalf of the natural person that he or she is entitled to receive a copy of the authorization form.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.700 Preparation of investigative consumer report; personal interview. (NRS 679B.130)
1. No insurance institution, agent or insurance-support organization may prepare or request an investigative consumer report about a natural person in connection with an insurance transaction involving an application for insurance, the renewal of a policy, the reinstatement of a policy or a change in insurance benefits unless the insurance institution or agent informs the natural person that:
(a) The natural person may request to be interviewed in connection with the preparation of the investigative consumer report; and
(b) Upon a request the natural person is entitled to receive a copy of the investigative consumer report.
2. In preparing an investigative consumer report the insurance institution or agent shall institute reasonable procedures to conduct a personal interview requested by a natural person.
3. If an investigative consumer report is to be prepared by an insurance-support organization, the insurance institution or agent desiring the report shall inform the insurance-support organization whether a personal interview has been requested by the natural person. The insurance-support organization shall institute reasonable procedures to conduct an interview, if requested.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.705 Access to recorded personal information. (NRS 679B.130)
1. If any natural person, after providing proper identification, submits a request in writing to an insurance institution, agent or insurance-support organization for access to recorded personal information about the natural person which is reasonably described by the natural person and can be reasonably located and retrieved by the insurance institution, agent or insurance-support organization, the insurance institution, agent or insurance-support organization shall within 30 business days after the date the request is received:
(a) Inform the natural person of the nature and substance of the recorded personal information in writing, by telephone or by other oral communication, whichever the insurance institution, agent or insurance-support organization prefers.
(b) Permit the natural person to see and copy, in person, recorded personal information pertaining to him or her or to obtain a copy of the recorded personal information by mail, whichever the natural person prefers. If the recorded personal information is in coded form, an accurate translation in plain language must be provided in writing.
(c) Disclose to the natural person the identity, if recorded, of those persons to whom the insurance institution, agent or insurance-support organization has disclosed the personal information within the preceding 2 years before receiving the request, and if the identity is not recorded, the names of those insurance institutions, agents, insurance-support organizations or other persons to whom the information is normally disclosed.
(d) Provide the natural person with a summary of the procedures by which he or she may request a correction, amendment or deletion of the recorded personal information.
2. Any personal information provided pursuant to subsection 1 must identify the source of the information if the source is an institutional source.
3. Medical record information supplied by a medical care institution or medical professional which is requested pursuant to subsection 1, and the identity of the medical professional or medical care institution which provided the information, must be supplied either directly to the natural person or to a medical professional designated by the natural person and licensed to provide medical care with respect to the condition to which the information relates, whichever the insurance institution, agent or insurance-support organization prefers. If the information is disclosed to a medical professional designated by the natural person, the insurance institution, agent or insurance-support organization shall notify the natural person, at the time of the disclosure, that it has provided the information to the medical professional.
4. Except for personal information provided under NAC 679B.715, an insurance institution, agent or insurance-support organization may charge a reasonable fee to cover the costs incurred in providing a copy of recorded personal information to natural persons.
5. The obligations imposed by this section upon an insurance institution or agent may be satisfied by another insurance institution or agent authorized to act on its behalf. With respect to the copying and disclosure of recorded personal information pursuant to a request made under subsection 1, an insurance institution, agent or insurance-support organization may make arrangements with an insurance-support organization or a consumer reporting agency to copy and disclose recorded personal information on its behalf.
6. The rights granted by this section extend to all natural persons to the extent information about them is collected and maintained by an insurance institution, agent or insurance-support organization in connection with an insurance transaction. The rights granted do not extend to information collected in connection with or in reasonable anticipation of a claim or a civil or criminal proceeding involving them.
7. For the purposes of this section, the term “insurance-support organization” does not include a consumer reporting agency except to the extent this section imposes more stringent requirements on a consumer reporting agency than any state or federal law.
(Added to NAC by Comm’r of Insurance, eff. 10-4-88)
NAC 679B.710 Correction, amendment or deletion of recorded personal information. (NRS 679B.130)
1. Within 30 business days after the postmark on a written request from a natural person to correct, amend or delete any recorded personal information about him or her within its possession, an insurance institution, agent or insurance-support organization shall:
(a) Correct, amend or delete the portion of the recorded personal information in dispute; or
(b) Notify the natural person of:
(1) Its refusal to make the correction, amendment or deletion;
(2) The reasons for the refusal; and
(3) The natural person’s right to file a statement as provided in subsection 3.
2. If the insurance institution, agent or insurance-support organization corrects, amends or deletes recorded personal information in accordance with paragraph (a) of subsection 1, the insurance institution, agent or insurance-support organization shall notify the natural person of this fact in writing and furnish the correction, amendment or deletion to:
(a) Any person specifically designated by the natural person who may have within the preceding 2 years received the recorded personal information;
(b) Any insurance-support organization whose primary source of personal information is insurance institutions if the insurance-support organization has systematically received the recorded personal information from the insurance institution within the preceding 7 years, unless the insurance-support organization no longer maintains recorded personal information about the natural person; and
(c) Any insurance-support organization that furnished the personal information that has been corrected, amended or deleted.
3. Whenever a natural person disagrees with an insurance institution’s, agent’s or insurance-support organization’s refusal to correct, amend or delete recorded personal information, the natural person may file with the insurance institution, agent or insurance-support organization a concise statement:
(a) Setting forth what the natural person thinks is the correct, relevant or fair information; and
(b) Of the reasons why the natural person disagrees with the refusal to correct, amend or delete recorded personal information.
4. If a natural person files either statement as described in subsection 3, the insurance institution, agent or insurance-support organization shall:
(a) File the statement with the disputed personal information and provide a means by which anyone reviewing the disputed personal information will be made aware of the natural person’s statement and have access to it;
(b) Clearly identify, in any subsequent disclosure by the insurance institution, agent or support organization of recorded personal information that is the subject of disagreement, the matter or matters in dispute and provide the natural person’s statement along with the recorded personal information being disclosed; and
(c) Distribute the statement pursuant to the provisions of subsection 2.
5. The rights granted to natural persons by this section extend to all natural persons to the extent information about them is collected and maintained by an insurance institution, agent or insurance-support organization in connection with an insurance transaction. The rights granted do not extend to information collected in connection with or in reasonable anticipation of a claim or a civil or criminal proceeding involving them.
6. For the purposes of this section, “insurance-support organization” does not include a consumer reporting agency except to the extent that this section imposes more stringent requirements on a consumer reporting agency than any state or federal law.
(Added to NAC by Comm’r of Insurance, eff. 10-4-88)
NAC 679B.715 Notification of reasons for adverse underwriting decision; summary of rights. (NRS 679B.130)
1. Except as otherwise provided in subsection 4, if an adverse underwriting decision occurs, the insurance institution or agent responsible for the decision shall:
(a) Provide the applicant, policyholder or natural person proposed for coverage with the specific reason or reasons for the adverse underwriting decision in writing or advise him or her that, upon submitting a request in writing, he or she may receive the specific reason or reasons in writing; and
(b) Provide the applicant, policyholder or natural person proposed for coverage with a summary of the rights established under subsection 2 and NAC 679B.705 and 679B.710.
2. Upon receiving a written request within 90 business days after notifying an applicant, policyholder or natural person proposed for coverage of an adverse underwriting decision, the insurance institution or agent shall furnish within 21 business days after the date of receiving the written request to the applicant, policyholder or natural person proposed for coverage:
(a) In writing, the specific reason or reasons for the adverse underwriting decision if the information was not initially furnished in writing pursuant to paragraph (a) of subsection 1; and
(b) The specific items of personal and privileged information that support those reasons, except that the insurance institution or agent:
(1) Is not required to furnish specific items of privileged information if it has a reasonable suspicion, based upon specific information available for review by the Commissioner, that the applicant, policyholder or natural person proposed for coverage has engaged in criminal activity, fraud, material misrepresentation or material nondisclosure.
(2) Has the option of disclosing information concerning specific items of medical record information supplied by a medical care institution or medical professional, including the names and addresses of the institutional sources of that information, to either the natural person about whom the information relates or to a medical professional designated by the natural person and licensed to provide medical care with respect to the condition to which the information relates.
3. The obligations imposed by this section upon an insurance institution or agent may be satisfied by another insurance institution or agent authorized to act on its behalf.
4. When an adverse underwriting decision results in an oral request or inquiry, the explanation of reasons and summary of rights required by subsection 1 may be given orally.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.720 Seeking information concerning previous adverse underwriting decision. (NRS 679B.130) No insurance institution, agent or insurance-support organization may seek in connection with an insurance transaction, information concerning:
1. Any previous adverse underwriting decision experienced by a natural person; or
2. Any previous insurance coverage obtained by a natural person through a residual market mechanism unless the inquiry also requests the reasons for the previous adverse underwriting decision or why insurance coverage was previously obtained through a residual market mechanism.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.725 Basis for adverse underwriting decision. (NRS 679B.130)
1. Except as otherwise provided in subsection 2, no insurance institution or agent may base an adverse underwriting decision in whole or in part on:
(a) A previous adverse underwriting decision;
(b) Insurance coverage previously obtained by a natural person through a residual market mechanism; or
(c) Personal information received from an insurance-support organization whose primary source of information is insurance institutions.
2. An insurance institution or agent may base an adverse underwriting decision on additional:
(a) Information obtained from an insurance institution or agent responsible for the previous adverse underwriting decision; or
(b) Personal information received from the insurance-support organization.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.730 Limitations upon and conditions of disclosure. (NRS 679B.130) An insurance institution, agent or insurance-support organization shall not disclose personal or privileged information about a natural person collected or received in connection with an insurance transaction unless the disclosure is:
1. Authorized in writing by the natural person and:
(a) If the authorization is submitted by a person other than an insurance institution, agent or insurance-support organization, the authorization is:
(1) Dated;
(2) Signed by the natural person; and
(3) Obtained not more than 1 year before the date a disclosure is sought pursuant to this section.
(b) If the authorization is submitted by another insurance institution, agent or insurance-support organization, the authorization meets the requirements of NAC 679B.695.
2. Directed to a person other than an insurance institution, agent or insurance-support organization, provided the disclosure is reasonably necessary:
(a) To enable the person to perform a business, professional or insurance function for the disclosing insurance institution, agent or insurance-support organization and the person agrees not to disclose the information further without the natural person’s written authorization unless the further disclosure:
(1) Would otherwise be permitted by this section if made by an insurance institution, agent or insurance-support organization; or
(2) Is reasonably necessary for the person to perform its function for the disclosing insurance institution, agent or insurance-support organization; or
(b) To enable the person to provide information to the disclosing insurance institution, agent or insurance-support organization in order to:
(1) Determine a natural person’s eligibility for an insurance benefit or payment; or
(2) Detect or prevent criminal activity, fraud, material misrepresentation or material nondisclosure in connection with an insurance transaction.
3. Directed to an insurance institution, agent, insurance-support organization, or self-insurer, if the information disclosed is limited to that which is reasonably necessary:
(a) To detect or prevent criminal activity, fraud, material misrepresentation or material nondisclosure in connection with insurance transactions; or
(b) For the disclosing or receiving insurance institution, agent or insurance-support organization to perform its function in connection with an insurance transaction involving the natural person.
4. Directed to a medical care institution or medical professional to:
(a) Verify insurance coverage or benefits;
(b) Inform a natural person of a medical problem of which the natural person may not be aware; or
(c) Conduct an operations or services audit to verify the natural persons treated by the medical professional or at the medical care institution, provided only information which is reasonably necessary to accomplish the foregoing purposes is disclosed.
5. Directed to an insurance regulatory authority.
6. Directed to a law enforcement or other governmental authority:
(a) To protect the interest of the insurance institution, agent or insurance-support organization in preventing or prosecuting the perpetration of fraud upon it; or
(b) If the insurance institution, agent or insurance-support organization reasonably believes that illegal activities have been conducted by the natural person.
7. Otherwise permitted or required by law.
8. In response to a facially valid administrative or judicial order, including a search warrant or subpoena.
9. Made to conduct actuarial or research studies, if:
(a) No natural person may be identified in any actuarial or research report;
(b) Materials allowing the natural person to be identified are returned or destroyed as soon as they are no longer needed; and
(c) The actuarial or research organization agrees that the information not be disclosed unless the disclosure would otherwise be permitted by this section if made by an insurance institution, agent or insurance-support organization.
10. Directed to a party or representative of a party to a proposed or consummated sale, transfer, merger or consolidation of all or part of the business of the insurance institution, agent or insurance-support organization, if:
(a) Before consummating the sale, transfer, merger or consolidation, only information that is reasonably necessary to enable the recipient to make business decisions about the purchase, transfer, merger or consolidation is disclosed; and
(b) The recipient agrees not to disclose the information unless the disclosure would otherwise be permitted by this section if made by an insurance institution, agent or insurance-support organization.
11. Directed to a person whose only use of the information will be in connection with the marketing of a product or service, if:
(a) No medical record information, privileged information, or personal information relating to a natural person’s character, personal habits, mode of living or general reputation is disclosed, and no classification derived from the information is disclosed;
(b) The natural person has been given an opportunity to indicate that he or she does not want personal information disclosed for marketing purposes and has given no indication that he or she does not want the information disclosed; and
(c) The person receiving the information agrees not to use it except in connection with the marketing of a product or service.
12. Directed to an affiliate whose only use of the information will be in connection with an audit of the insurance institution or agent or the marketing of an insurance product or service, if the affiliate agrees not to disclose the information for any other purpose or to unaffiliated persons.
13. Made by a consumer reporting agency, if the disclosure is to a person other than an insurance institution or agent.
14. Directed to a group policyholder to report claims experience or conduct an audit of the insurance institution’s or agent’s operations or services, if the information disclosed is reasonably necessary for the group policyholder to conduct the review or audit.
15. Directed to a professional peer review organization to review the service or conduct of a medical care institution or medical professional.
16. Directed to a governmental authority to determine the natural person’s eligibility for health benefits for which the governmental authority may be liable.
17. Directed to a certificate holder or policyholder to provide information regarding the status of an insurance transaction.
18. Directed to a lienholder, mortgagee, assignee, lessor or other person shown on the records of an insurance institution or agent as having a legal or beneficial interest in a policy of insurance, if:
(a) No medical record information is disclosed unless the disclosure would otherwise be permitted by this section; and
(b) The information disclosed is limited to that which is reasonably necessary to permit the person to protect his or her interests in the policy.
(Added to NAC by Comm’r of Insurance, eff. 10-4-88)
NAC 679B.735 Investigation by Commissioner. (NRS 679B.130) The Commissioner may examine and investigate the affairs of every:
1. Insurance institution or agent doing business in this State to determine whether the insurance institution or agent has been or is engaged in any conduct violating NAC 679B.560 to 679B.750, inclusive.
2. Insurance-support organization acting on behalf of an insurance institution or agent transacting business within or outside this State which has an effect on a person residing in this State in order to determine whether the insurance-support organization has been or is engaged in any conduct violating NAC 679B.560 to 679B.750, inclusive.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.740 Hearings. (NRS 679B.130) Any hearings concerning conduct which violates NAC 679B.560 to 679B.750, inclusive, will be held pursuant to the provisions of this chapter and chapter 679B of NRS.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.745 Service of process on insurance-support organization outside of State. (NRS 679B.130) For the purposes of NAC 679B.560 to 679B.750, inclusive, an insurance-support organization transacting business outside this State and having an effect on a person residing in this State shall be deemed to have appointed the Commissioner to accept service of process on its behalf, if the Commissioner causes a copy of any service to be mailed forthwith by registered mail to the insurance-support organization at its last known principal place of business. The return postcard receipt for registered mailing is sufficient proof that a copy of the service was properly mailed by the Commissioner.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
NAC 679B.750 Penalties. (NRS 679B.130)
1. If the Commissioner determines that there has been a knowing violation of NAC 679B.675 to 679B.730, inclusive, he or she may:
(a) Issue a cease and desist order following notice and a hearing on the violation.
(b) Order payment of a monetary penalty of not more than $2,000 for each violation.
2. Any person who knowingly violates a cease and desist order of the Commissioner will be subject to one or more of the following penalties, at the discretion of the Commissioner:
(a) A monetary fine of not more than $2,000 for each violation;
(b) A monetary fine of not more than $2,000 if the Commissioner finds that violations have occurred often enough to constitute a general business practice; or
(c) Suspension or revocation of an insurance institution’s or agent’s license.
(Added to NAC by Comm’r of Insurance, 10-4-88, eff. 1-1-89)
PROCESSING OF CLAIMS FOR PHARMACY BENEFITS
NAC 679B.775 Definitions. (NRS 679B.130) As used in NAC 679B.775 to 679B.795, inclusive, unless the context otherwise requires, the words and terms defined in NAC 679B.780, 679B.785 and 679B.790 have the meanings ascribed to them in those sections.
(Added to NAC by Comm’r of Insurance by R010-02, 9-13-2002)
NAC 679B.780 “Health care plan” defined. (NRS 679B.130) “Health care plan” has the meaning ascribed to it in NRS 679B.520.
(Added to NAC by Comm’r of Insurance by R010-02, 9-13-2002)
NAC 679B.785 “Insured” defined. (NRS 679B.130) “Insured” has the meaning ascribed to it in NRS 679B.530.
(Added to NAC by Comm’r of Insurance by R010-02, 9-13-2002)
NAC 679B.790 “Insurer” defined. (NRS 679B.130) “Insurer” has the meaning ascribed to it in NRS 679B.540.
(Added to NAC by Comm’r of Insurance by R010-02, 9-13-2002)
NAC 679B.795 Prohibited acts by insurer. (NRS 679B.130) An insurer that issues a health care plan shall not:
1. Delay or deny the payment of any claim for pharmacy benefits solely on the basis that the person who wrote the prescription does not have a valid registration number issued by the Drug Enforcement Administration; or
2. Use a false registration number to process such a claim.
(Added to NAC by Comm’r of Insurance by R010-02, 9-13-2002)
DISCLOSURE OF NONPUBLIC PERSONAL FINANCIAL INFORMATION
General Provisions
NAC 679B.800 Definitions. (NRS 679B.130, 686A.025) As used in NAC 679B.800 to 679B.878, inclusive, unless the context otherwise requires, the words and terms defined in NAC 679B.802 to 679B.832, inclusive, have the meanings ascribed to them in those sections.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002; A by R125-18, 10-25-2018)
NAC 679B.802 “Affiliate” defined. (NRS 679B.130, 686A.025) “Affiliate” means any company that controls, is controlled by or is under common control with another company.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.804 “Clear and conspicuous” defined. (NRS 679B.130, 686A.025)
1. “Clear and conspicuous” means that a notice is reasonably understandable and designed to call attention to the nature and significance of the information in the notice.
2. For the purposes of this section, a notice from a licensee is:
(a) “Designed to call attention to the nature and significance of the information in the notice” if the notice:
(1) Uses a heading in plain language to call attention to the notice;
(2) Uses a typeface and a type size that are easy to read;
(3) Provides wide margins and ample line spacing;
(4) Uses boldface and italics type for key words; and
(5) Uses distinctive type size and style, and graphic devices, including, without limitation, shading and sidebars, in a form that combines the notice from a licensee with other information.
(b) “Reasonably understandable” if the notice:
(1) Presents the information in the notice in clear, concise sentences, paragraphs and sections;
(2) Uses short explanatory sentences or bullet lists whenever possible;
(3) Avoids multiple negatives;
(4) Whenever possible, avoids legal and business terminology that is highly technical; and
(5) Avoids explanations that are imprecise and readily subject to different interpretations.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.806 “Collect” defined. (NRS 679B.130, 686A.025) “Collect” means to obtain any information that a licensee organizes or can retrieve by:
1. The name of a natural person; or
2. An identifying number, symbol or other identifying particular assigned to the natural person.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.808 “Company” defined. (NRS 679B.130, 686A.025) “Company” means a corporation, limited-liability company, business trust, general partnership, limited partnership, association, sole proprietorship or similar organization.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.810 “Consumer” defined. (NRS 679B.130, 686A.025)
1. “Consumer” means a natural person, or the legal representative of a natural person:
(a) Who seeks to obtain or has obtained an insurance product or service from a licensee that is to be used primarily for personal, family or household purposes; and
(b) About whom the licensee has nonpublic personal financial information.
2. The term includes:
(a) A natural person who provides nonpublic personal financial information to a licensee in connection with obtaining or seeking to obtain financial, investment or economic advisory services relating to an insurance product or service, regardless of whether the licensee establishes an ongoing advisory relationship.
(b) An applicant for insurance before the inception of insurance coverage.
(c) If the licensee discloses nonpublic personal financial information about the natural person to a nonaffiliated third party other than a third party authorized to receive such information pursuant to NAC 679B.870, 679B.872 and 679B.874, a natural person who is:
(1) An insured pursuant to a policy issued by the licensee;
(2) An annuitant pursuant to an annuity issued by the licensee; or
(3) A mortgagor of a mortgage covered by a mortgage insurance policy.
(d) If the licensee does not meet all the conditions set forth in paragraph (d) of subsection 3, a natural person who is a holder of a contract for a group annuity.
3. The term does not include:
(a) A natural person who is a consumer of another financial institution solely because the licensee is acting as agent for, or provides processing or other services to, that financial institution.
(b) A natural person solely because he or she is a beneficiary of a trust for which the licensee is a trustee.
(c) A natural person solely because he or she has designated the licensee as trustee for a trust.
(d) If a licensee provides the initial, annual and revised notices pursuant to NAC 679B.842, 679B.844 and 679B.860, respectively, to the holder of a contract for a group annuity, the holder of a contract for group or blanket insurance or the sponsor of an employee benefit plan that the licensee administers or sponsors or for which the licensee acts as a trustee, insurer or fiduciary, and if, except as otherwise provided in NAC 679B.870, 679B.872 and 679B.874, a licensee does not disclose nonpublic personal financial information to a nonaffiliated third party about such a natural person, a natural person solely because he or she is:
(1) A participant in or a beneficiary of an employee benefit plan that the licensee administers or sponsors or for which the licensee acts as a trustee, insurer or fiduciary; or
(2) Covered by a contract for a group annuity or group or blanket insurance issued by the licensee.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.812 “Consumer reporting agency” defined. (NRS 679B.130, 686A.025) “Consumer reporting agency” has the meaning ascribed to it in 15 U.S.C. § 1681a(f) of the Fair Credit Reporting Act.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.814 “Control” defined. (NRS 679B.130, 686A.025) “Control” means:
1. Ownership or power to vote, directly or indirectly, 25 percent or more of the outstanding shares of any class of voting security of the company;
2. Directing, in any manner, the election of a majority of the directors, trustees, general partners or other persons exercising similar functions of the company; or
3. The power to exercise, directly or indirectly, a controlling influence over the management or policies of the company.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.816 “Customer” defined. (NRS 679B.130, 686A.025)
1. “Customer” means a consumer who has a customer relationship with a licensee.
2. The term does not include a natural person solely because of his or her status as an annuitant pursuant to a contract for a group annuity issued by the licensee.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.818 “Customer relationship” defined. (NRS 679B.130, 686A.025)
1. “Customer relationship” means a continuing relationship between a consumer and a licensee in which the licensee provides one or more insurance products or services to the consumer that are to be used primarily for personal, family or household purposes.
2. For the purposes of this section:
(a) A consumer has a “continuing relationship” with a licensee if:
(1) A consumer is a current policyholder of an insurance product issued by or through the licensee; or
(2) A consumer obtains financial, investment or economic advisory services relating to an insurance product or service from the licensee for a fee.
(b) A consumer does not have a “continuing relationship” with a licensee if:
(1) A consumer applies for insurance, but does not purchase the insurance;
(2) A licensee sells the consumer airline travel insurance in an isolated transaction;
(3) A natural person is no longer a current policyholder of an insurance product or no longer obtains insurance services with or through the licensee;
(4) The consumer is a claimant pursuant to a policy and has submitted a claim for a settlement option involving an ongoing relationship with the licensee pursuant to the policy;
(5) The consumer is a claimant pursuant to a policy and has submitted a claim for a lump-sum settlement option pursuant to the policy;
(6) The policy of a consumer is lapsed, expired or otherwise inactive or dormant pursuant to the business practices of the licensee, and, other than annual privacy notices, material required by law or regulation, communication at the direction of a state or federal authority, or promotional materials, the licensee has not communicated with the customer about the relationship for a period of 12 consecutive months;
(7) The natural person is an insured or an annuitant pursuant to an insurance policy or annuity, respectively, but is not the policyholder or owner of the insurance policy or annuity; or
(8) The last known address of a natural person according to the records of a licensee is deemed invalid.
(c) A licensee establishes a “customer relationship” when the consumer:
(1) Becomes a policyholder of a licensee that is an insurer when the insurer delivers an insurance policy or contract to the consumer;
(2) In the case of a licensee that is an insurance producer or surplus line broker, obtains insurance through that licensee; or
(3) Agrees to obtain financial, economic or investment advisory services relating to insurance products or services for a fee from the licensee.
(d) An address of record is deemed “invalid” if:
(1) Mail sent to the address of record by the licensee has been returned as undeliverable; and
(2) Subsequent attempts by the licensee to obtain a current valid address for the natural person have been unsuccessful.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.820 “Financial institution” defined. (NRS 679B.130, 686A.025)
1. “Financial institution” means any institution engaged in activities that are financial in nature or incidental to such financial activities as described in 12 U.S.C. § 1843(k) of the Bank Holding Company Act of 1956.
2. The term does not include:
(a) Any person or entity with respect to any financial activity that is subject to the jurisdiction of the Commodity Futures Trading Commission pursuant to the Commodity Exchange Act, 7 U.S.C. §§ 1 et seq.;
(b) The Federal Agricultural Mortgage Corporation or any similar entity operating pursuant to the Farm Credit Act of 1971, 12 U.S.C. §§ 2001 et seq.; or
(c) If an institution does not sell or transfer nonpublic personal financial information to a nonaffiliated third party, an institution chartered by Congress specifically to engage in:
(1) Securitizations;
(2) Secondary market sales, including, without limitation, sales of servicing rights; or
(3) Similar transactions related to a transaction of a consumer.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.822 “Insurance product or service” defined. (NRS 679B.130, 686A.025)
1. “Insurance product or service” means any product or service that is offered by a licensee pursuant to the insurance laws of this State.
2. The term includes an evaluation, brokerage or distribution of information that the licensee collects in connection with a request or an application from a consumer for an insurance product or service.
3. The term does not include:
(a) Insurance products or services that are not used primarily for personal, family or household purposes; or
(b) Products or services for health care coverage.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.824 “Licensee” defined. (NRS 679B.130, 686A.025)
1. “Licensee” means all:
(a) Authorized insurers;
(b) Licensed producers; and
(c) Other persons who, pursuant to the insurance laws of this State, are:
(1) Licensed, authorized or registered, except pursuant to chapter 690C of NRS; or
(2) Required to be licensed, authorized or registered.
2. The term includes an unauthorized insurer that accepts business placed through a surplus lines broker who is licensed in this State, but only with regard to the placement of surplus lines pursuant to chapter 685A of NRS.
3. The term does not include service contract providers or persons licensed pursuant to chapter 690C of NRS.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.826 “Nonaffiliated third party” defined. (NRS 679B.130, 686A.025)
1. “Nonaffiliated third party” means any person except:
(a) An affiliate of a licensee; or
(b) A person employed jointly by a licensee and any company that is not the affiliate of a licensee.
2. The term includes:
(a) Any other company that jointly employs the person; or
(b) Any company that is an affiliate solely by direct or indirect ownership, or control of the company by the licensee or its affiliate in conducting:
(1) Merchant banking or investment banking activities of the type described in 12 U.S.C. § 1843(k)(4)(H) of the Bank Holding Company Act of 1956; or
(2) Insurance company investment activities of the type described in 12 U.S.C. § 1843(k)(4)(I) of the Bank Holding Company Act of 1956.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.828 “Nonpublic personal financial information” defined. (NRS 679B.130, 686A.025)
1. “Nonpublic personal financial information” means:
(a) Personally identifiable financial information; and
(b) Any list, description or other grouping of consumers and publicly available information regarding consumers that is derived using any personally identifiable financial information which is not publicly available.
2. The term includes any list of names and street addresses of natural persons that is derived in whole or in part using personally identifiable financial information which is not publicly available, including, without limitation, account numbers.
3. The term does not include:
(a) Except as otherwise provided in NAC 679B.800 to 679B.878, inclusive, publicly available information;
(b) Any list, description or other grouping of consumers and publicly available information pertaining to such consumers that is derived without using any personally identifiable financial information which is not publicly available;
(c) Any list of names and addresses of natural persons that:
(1) Contains only publicly available information;
(2) Is not derived in whole or in part using personally identifiable financial information which is not publicly available; and
(3) Is not disclosed in a manner which indicates that any of the natural persons on the list is a consumer of a financial institution; or
(d) Any information related to health care or workers’ compensation coverage.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.829 “Nonpublic personal health information” defined. (NRS 679B.130, 686A.025) “Nonpublic personal health information” means health information:
1. That identifies a person who is the subject of the information; or
2. With respect to which there is a reasonable basis to believe that the information could be used to identify a person.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8295 “Nonpublic personal information” defined. (NRS 679B.130, 686A.025) “Nonpublic personal information” means:
1. Nonpublic personal financial information; and
2. Nonpublic personal health information.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.830 “Personally identifiable financial information” defined. (NRS 679B.130, 686A.025)
1. “Personally identifiable financial information” means any information:
(a) That a consumer provides to a licensee to obtain an insurance product or service from the licensee;
(b) About a consumer resulting from a transaction involving an insurance product or service between a licensee and a consumer; or
(c) That the licensee otherwise obtains about a consumer in connection with providing an insurance product or service to that consumer.
2. The term includes:
(a) Information that a consumer provides to a licensee on an application to obtain an insurance product or service;
(b) Account balance information and payment history;
(c) The fact that a natural person is or has been one of the customers of the licensee or has obtained an insurance product or service from the licensee;
(d) Any information about the consumer of the licensee if it is disclosed in a manner which indicates that the natural person is or has been a consumer of the licensee;
(e) Any information which a consumer provides to a licensee or which the licensee or its agent otherwise obtains in connection with collecting on a loan or servicing a loan;
(f) Any information that the licensee collects through an Internet cookie or other similar devices for collecting information on a web server; and
(g) Information from a consumer report.
3. The term does not include:
(a) A list of names and addresses of customers of an entity that is not a financial institution;
(b) Information that does not identify a consumer;
(c) Aggregate information or blind data that does not contain personal identifiers, including, without limitation:
(1) Account numbers;
(2) Names; or
(3) Addresses; or
(d) Any information related to health care or workers’ compensation coverage.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.832 “Publicly available information” defined. (NRS 679B.130, 686A.025)
1. “Publicly available information” means any information that a licensee has a reasonable basis to believe is lawfully made available to the general public from:
(a) Federal, state or local governmental records;
(b) Widely distributed media; or
(c) Disclosures to the general public that are required to be made by federal, state or local law.
2. For the purposes of this section:
(a) Publicly available information from federal, state or local governmental records may include information in governmental real estate records and security interest filings.
(b) Publicly available information from widely distributed media may include information from a:
(1) Telephone book;
(2) Television;
(3) Radio program;
(4) Newspaper; or
(5) Website that is available to the general public on an unrestricted basis.
(c) If access is available to the general public, a website is not restricted solely because an Internet service provider or a site operator requires a fee or a password.
(d) A licensee has a reasonable basis to believe that:
(1) Information is lawfully made available to the general public if the licensee has taken steps to determine:
(I) That the information is of the type that is available to the general public; and
(II) Whether a natural person can direct that the information not be made available to the general public and, if so, that the consumer has not done so.
(2) Mortgage information is lawfully made available to the general public if the licensee has determined that the information is of the type included in the public record of the jurisdiction where the mortgage is or will be recorded.
(3) A telephone number of a natural person is lawfully made available to the general public if:
(I) The licensee has located the telephone number in a telephone book; or
(II) The consumer has informed the licensee that the telephone number is listed.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.834 Scope. (NRS 679B.130, 686A.025) The provisions of NAC 679B.800 to 679B.878, inclusive, govern the disclosure and use of nonpublic personal financial information about natural persons by all licensees.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.836 Applicability. (NRS 679B.130, 686A.025)
1. The provisions of NAC 679B.800 to 679B.878, inclusive, apply to nonpublic personal financial information regarding a natural person who obtains products or services primarily for personal, family or household purposes from a licensee.
2. The provisions of NAC 679B.800 to 679B.878, inclusive, do not apply to information about companies or about natural persons who obtain products or services for business, commercial or agricultural purposes.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.838 Limitations on construction of provisions. (NRS 679B.130, 686A.025) The provisions of NAC 679B.800 to 679B.878, inclusive, must not be construed to:
1. Interfere with or supersede other applicable provisions of NRS or NAC related to medical records, or the privacy of health or insurance information, including, without limitation, the provisions of NAC 679B.560 to 679B.750, inclusive.
2. Modify, limit or supersede the operation of the Fair Credit Reporting Act, 15 U.S.C. §§ 1681 et seq.
3. Imply that information is transaction or experience information pursuant to the Fair Credit Reporting Act, 15 U.S.C. §§ 1681 et seq.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.840 Severability. (NRS 679B.130, 686A.025)
1. The provisions of NAC 679B.800 to 679B.878, inclusive, are hereby declared to be severable.
2. If any provision of NAC 679B.800 to 679B.878, inclusive, is held invalid, or if the application of any such provision to any person, thing or circumstance is held invalid, such invalidity does not affect any other provision of NAC 679B.800 to 679B.878, inclusive, that can be given effect without the invalid provision or application.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
Programs for the Security of Customer Information
NAC 679B.841 Definitions. (NRS 679B.130, 679B.137, 686A.025) As used in NAC 679B.841 to 679B.8417, inclusive, unless the context otherwise requires, the words and terms defined in NAC 679B.8412, 679B.8413 and 679B.8414 have the meanings ascribed to them in those sections.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8412 “Customer information” defined. (NRS 679B.130, 679B.137, 686A.025) “Customer information” means nonpublic personal information about a customer, whether in paper, electronic or other form, that is maintained by or on behalf of the licensee.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8413 “Customer information system” defined. (NRS 679B.130, 679B.137, 686A.025) “Customer information system” means the electronic or physical methods used to access, collect, store, use, transmit, protect or dispose of customer information.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8414 “Service provider” defined. (NRS 679B.130, 679B.137, 686A.025) “Service provider” means a person who maintains, processes or is otherwise allowed access to customer information through the person’s provision of services directly to the licensee.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8415 Licensee: Requirements for written program. (NRS 679B.130, 679B.137, 686A.025) Each licensee shall implement a comprehensive written program for the security of customer information. The program must include administrative, technical and physical safeguards for the protection of customer information. Such administrative, technical and physical safeguards must be appropriate for the size and complexity of the licensee and the nature and scope of the licensee’s activities.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8416 General requirements for design of program. (NRS 679B.130, 679B.137, 686A.025) A program implemented pursuant to NAC 679B.8415 for the security of customer information must be designed to:
1. Ensure the security and confidentiality of customer information;
2. Protect against any anticipated threat or hazard to the security and integrity of the customer information; and
3. Protect against unauthorized access to, or use of, the customer information that could result in substantial harm or inconvenience to a customer.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
NAC 679B.8417 Factors considered by Commissioner in determining whether program is satisfactory. (NRS 679B.130, 679B.137, 686A.025) To determine whether a program implemented pursuant to NAC 679B.8415 is satisfactory, the Commissioner will consider:
1. The manner in which, in order to assess risk, the licensee:
(a) Identifies reasonably foreseeable internal and external threats or hazards which could result in the unauthorized disclosure, misuse, alteration or destruction of customer information or customer information systems;
(b) Assesses the likelihood and potential damage of the threats or hazards, taking into consideration the sensitivity of the customer information; and
(c) Assesses the sufficiency of policies, procedures, safeguards and customer information systems to manage and control risks.
2. Whether, in order to manage and control risk, the licensee:
(a) Designs such a program to control the identified risks, commensurate with the sensitivity of the customer information and the complexity and scope of the licensee’s activities;
(b) Trains staff, as appropriate, to implement the program; and
(c) Regularly tests or monitors the key controls, systems and procedures of the program. The frequency and nature of such tests or monitoring practices must be determined by the risk assessment performed by the licensee.
3. Whether, in order to oversee arrangements with service providers, the licensee:
(a) Exercises due diligence in selecting service providers;
(b) Requires service providers to implement appropriate measures designed to meet the objectives of this section; and
(c) Takes appropriate steps to confirm that service providers have satisfied the requirements imposed pursuant to paragraph (b).
4. Whether the licensee monitors, evaluates and adjusts, as appropriate, such a program considering:
(a) Relevant changes in technology;
(b) Changes in customer information systems;
(c) The sensitivity of customer information;
(d) Internal and external threats or hazards to the customer information; and
(e) Changes in the business arrangements of the licensee, including, without limitation, mergers, acquisitions, alliances, joint ventures and outsourcing arrangements.
5. Any other information which the Commissioner deems relevant to the determination.
(Added to NAC by Comm’r of Insurance by R125-18, eff. 10-25-2018)
Privacy and Opt-Out Notices
NAC 679B.842 Initial privacy notice to consumers required. (NRS 679B.130, 686A.025)
1. Except as otherwise provided in this section, a licensee shall provide a clear and conspicuous notice that accurately reflects the privacy policies and practices of the licensee to:
(a) A natural person who becomes a customer of the licensee not later than when the licensee establishes a customer relationship.
(b) If the licensee makes a disclosure other than as authorized by NAC 679B.872 and 679B.874, a consumer before the licensee discloses any nonpublic personal financial information about the consumer to a nonaffiliated third party.
2. A licensee is not required to provide an initial notice to a consumer pursuant to paragraph (b) of subsection 1 if:
(a) A notice has been provided by an affiliated licensee, which notice clearly and accurately identifies all licensees and other institutions to whom the notice applies; or
(b) The licensee does not:
(1) Disclose any nonpublic personal financial information about the consumer to any nonaffiliated third party, other than a disclosure authorized by NAC 679B.872 and 679B.874; and
(2) Have a customer relationship with the consumer.
3. When an existing customer obtains a new insurance product or service from a licensee that is to be used primarily for personal, family or household purposes, the licensee satisfies the initial notice requirements of subsection 1 by providing a revised policy notice pursuant to NAC 679B.860 that covers the new insurance product or service obtained by the customer.
4. If the initial, revised or annual notice that the licensee most recently provided to that customer was accurate with respect to the new insurance product or service, the licensee is not required to provide a new privacy notice pursuant to subsection 1.
5. A licensee may provide the initial notice required by paragraph (a) of subsection 1 within a reasonable time after the licensee establishes a customer relationship if:
(a) Establishing the customer relationship is not at the election of the customer; or
(b) Providing a notice not later than when the licensee establishes a customer relationship:
(1) Would substantially delay the transaction of the customer; and
(2) The customer agrees to receive the notice at a later time.
6. For the purposes of subsection 5:
(a) A notice provided not later than when a licensee establishes a customer relationship substantially delays the transaction of a customer if the licensee and the natural person agree over the telephone to enter into a customer relationship involving the prompt delivery of the insurance product or service.
(b) A notice provided not later than when a licensee establishes a customer relationship does not substantially delay the transaction of a customer if the relationship is initiated in person at the office of the licensee or through other means by which the customer may view the notice, including, without limitation, a website containing the notice.
7. If a licensee is required to deliver an initial privacy notice pursuant to this section, the licensee shall deliver the notice in the manner provided in NAC 679B.862.
8. If a licensee uses a short form initial notice for noncustomers pursuant to NAC 679B.848, the licensee may deliver its privacy notice in the manner provided in NAC 679B.862.
9. For the purposes of this section, a customer relationship is not established at the election of a customer if:
(a) A licensee acquires or is assigned a policy of a customer from another financial institution or residual market mechanism; and
(b) The customer does not have a choice about the acquisition or assignment of the policy by the licensee.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.844 Annual privacy notice to customers required; exception. (NRS 679B.130, 686A.025)
1. Except as otherwise provided in subsection 3, a licensee shall provide a clear and conspicuous notice to customers that accurately reflects privacy policies and practices of the licensee not less than annually during the continuation of the customer relationship. A licensee may define the beginning of the period of 12 consecutive months, but the licensee must apply the period to customers on a consistent basis.
2. A licensee provides a notice annually if the licensee:
(a) Defines the period of 12 consecutive months as a calendar year; and
(b) Provides the annual notice to the customer once in each calendar year following the calendar year in which the licensee provided the initial notice.
3. A licensee is not required to provide a notice pursuant to subsection 1 if the licensee:
(a) Solely provides nonpublic personal information to nonaffiliated third parties pursuant to NAC 679B.870, 679B.872 or 679B.874; and
(b) Has not changed its policies and practices relating to the disclosure of nonpublic personal information from those policies and practices that were set forth in the most recent notice sent to customers pursuant to the provisions of this section or NAC 679B.842.
Ê A licensee who changes its policies and practices relating to the disclosure of nonpublic personal information and has not provided a notice to its customers within the immediately preceding 12 consecutive months as allowed by this subsection shall provide its customers with a notice reflecting those policies and practices.
4. A licensee is not required to provide an annual notice to a former customer.
5. A licensee no longer has a continuing relationship with a natural person if:
(a) The natural person no longer is a current policyholder of an insurance product or no longer obtains insurance services with or through the licensee.
(b) The policy of a natural person has lapsed, expired or is otherwise inactive or dormant pursuant to the business practices of the licensee, and the licensee has not communicated with the customer about the relationship for a period of 12 consecutive months, other than to provide annual privacy notices, material required by law or regulation, or promotional materials.
(c) The last known address of a natural person according to the records of the licensee is invalid.
6. A licensee no longer has a “continuing relationship” with a customer in the case of providing real estate settlement services if, at the time the customer completes execution of all documents related to the real estate closing:
(a) Payment for those services has been received; or
(b) The licensee has completed all of his or her responsibilities with respect to the settlement, including, without limitation, filing documents on the public record,
Ê whichever occurs later.
7. A licensee shall deliver the annual privacy notice required pursuant to this section in the manner provided by NAC 679B.862.
8. For purposes of this section:
(a) “A former customer” is a natural person with whom a licensee no longer has a continuing relationship.
(b) “Annually” means at least once in any period of 12 consecutive months during which the customer relationship exists.
(c) An address of record shall be deemed “invalid” if:
(1) Mail sent to that address by the licensee has been returned as undeliverable; and
(2) Subsequent attempts by the licensee to obtain a current valid address for the natural person have been unsuccessful.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002; A by R125-18, 10-25-18)
NAC 679B.846 Information to be included in privacy notices: General items; description of parties subject to exceptions; categories of information collected and disclosed; categories of affiliates and nonaffiliated third parties to whom information disclosed. (NRS 679B.130, 686A.025)
1. In addition to any other information the licensee wishes to provide that applies to the licensee and to the consumers to whom the licensee sends a privacy notice, the initial, annual and revised privacy notices that a licensee provides pursuant to NAC 679B.842, 679B.844 and 679B.860, respectively, must include the following items of information:
(a) The categories of nonpublic personal financial information that the licensee collects.
(b) The categories of nonpublic personal financial information about the customers and former customers of the licensee that the licensee discloses.
(c) The categories of affiliates and nonaffiliated third parties to whom the licensee discloses nonpublic personal financial information, other than those parties to whom the licensee discloses information pursuant to NAC 679B.872 and 679B.874.
(d) The categories of affiliates and nonaffiliated third parties to whom the licensee discloses nonpublic personal financial information about the former customers of the licensee, other than those parties to whom the licensee discloses information pursuant to NAC 679B.872 and 679B.874.
(e) If a licensee discloses nonpublic personal financial information to a nonaffiliated third party pursuant to NAC 679B.870, and no other exception in NAC 679B.872 and 679B.874 applies to that disclosure, a separate description of the categories of information the licensee discloses and the categories of third parties with whom the licensee has contracted.
(f) An explanation of the right of the consumer pursuant to NAC 679B.864 to opt out of the disclosure of nonpublic personal financial information to nonaffiliated third parties, including, without limitation, the methods by which the consumer may exercise that right at that time.
(g) Any disclosures that the licensee makes pursuant to 15 U.S.C. § 1681a(d)(2)(A)(iii) of the Fair Credit Reporting Act, which concerns notices of the ability to opt out of disclosures of information among certain affiliates.
(h) The policies and practices of the licensee with respect to protecting the confidentiality and security of nonpublic personal financial information.
(i) Any disclosure that the licensee makes pursuant to subsection 2.
2. If a licensee discloses nonpublic personal financial information as authorized pursuant to NAC 679B.872 and 679B.874, the licensee is not required to list those exceptions in the initial or annual privacy notices required by NAC 679B.842 and 679B.844, respectively.
3. When describing the categories of parties to whom a disclosure is made, a licensee is required to state only that the disclosures are made to other affiliated or nonaffiliated third parties, if applicable, as permitted by law.
4. A licensee satisfies the requirement to categorize the nonpublic personal financial information collected by the licensee if the licensee categorizes the information according to the source of the information as follows:
(a) Information from the consumer;
(b) Information about the transactions of the consumer with the licensee or affiliates of the licensee;
(c) Information about the transactions of the consumer with nonaffiliated third parties; and
(d) Information from a consumer reporting agency.
5. A licensee satisfies the requirement to categorize nonpublic personal financial information disclosed by the licensee if the licensee categorizes the information according to the source of the information, as described in subsection 4, as applicable, and provides examples to illustrate the types of information in each category. These may include:
(a) Information from the consumer, including application information, such as assets and income, and identifying information, such as name, address and social security number;
(b) Transaction information, such as information about balances, payment history and parties to the transaction; and
(c) Information from consumer reports, such as a consumer’s creditworthiness and credit history.
6. A licensee does not adequately categorize the information that it discloses if the licensee uses only general terms, such as transaction information about the consumer.
7. If a licensee reserves the right to disclose all the nonpublic personal financial information about consumers that it collects, the licensee may simply state that fact without describing the categories or examples of nonpublic personal financial information that the licensee discloses.
8. A licensee satisfies the requirement to categorize the affiliates and nonaffiliated third parties to which the licensee discloses nonpublic personal financial information about consumers if the licensee identifies the types of businesses in which they engage. The types of businesses may be described in general terms only if the licensee uses illustrative examples of significant lines of business. A licensee may use the term “financial products or services” if it includes appropriate examples of significant lines of businesses, including, without limitation:
(a) A life insurer;
(b) An automobile insurer; or
(c) A consumer banking or securities brokerage.
9. A licensee may categorize the affiliates and nonaffiliated third parties to which it discloses nonpublic personal financial information about consumers using more detailed categories.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.848 Other information to be included in certain privacy notices; short form initial notice for noncustomers. (NRS 679B.130, 686A.025)
1. If a licensee discloses nonpublic personal financial information pursuant to the exception in NAC 679B.870 to a nonaffiliated third party to market products or services that the licensee offers alone or jointly with another financial institution, the licensee satisfies the disclosure requirement of paragraph (f) of subsection 1 of NAC 679B.846 if the licensee:
(a) Lists the categories of nonpublic personal financial information it discloses, using the same categories and examples the licensee used to meet the requirements of NAC 679B.846, if applicable; and
(b) States whether the third party is:
(1) A service provider that performs marketing services on behalf of the licensee, or on behalf of the licensee and another financial institution; or
(2) A financial institution with whom the licensee has a joint marketing agreement.
2. If a licensee does not disclose, and does not wish to reserve the right to disclose, nonpublic personal financial information about customers or former customers to affiliates or nonaffiliated third parties except as authorized pursuant to NAC 679B.872 and 679B.874, the licensee may simply state that fact, in addition to the information required pursuant to paragraphs (a), (h) and (i) of subsection 1 and subsection 2 of NAC 679B.846.
3. A licensee describes its policies and practices with respect to protecting the confidentiality and security of nonpublic personal financial information if the licensee does both of the following:
(a) Describes in general terms who is authorized to have access to the information; and
(b) States whether the licensee has security practices and procedures in place to ensure the confidentiality of the information in accordance with the policy of the licensee. The licensee is not required to describe technical information about the safeguards used by the licensee.
4. A licensee may satisfy the initial notice requirements of NAC 679B.842 and 679B.856 for a consumer who is not a customer by providing a short form initial notice at the same time as the licensee delivers an opt-out notice pursuant to NAC 679B.856.
5. A short form initial notice must:
(a) Be clear and conspicuous;
(b) State that the privacy notice of the licensee is available upon request; and
(c) Explain a reasonable means for the consumer to obtain the notice.
6. A licensee shall deliver the short form initial notice in the manner provided by NAC 679B.862. A licensee is not required to deliver the privacy notice with the short form initial notice. A licensee may provide the consumer with a reasonable means to obtain the privacy notice. If a consumer who receives the short form notice of the licensee requests the privacy notice of the licensee, the licensee shall deliver the privacy notice in the manner provided by NAC 679B.862.
7. The licensee’s notice may include:
(a) Categories of nonpublic personal financial information that the licensee reserves the right to disclose in the future, but does not currently disclose; and
(b) Categories of affiliates or nonaffiliated third parties to whom the licensee reserves the right in the future to disclose, but to whom the licensee does not currently disclose, nonpublic personal financial information.
8. For the purposes of this section, a licensee provides a reasonable means for a consumer to obtain a copy of the privacy notice of the licensee if the licensee:
(a) Provides a toll-free telephone number that the consumer may call to request the notice; or
(b) For a consumer who conducts business in person at the offices of the licensee, maintains copies of the notice on hand that the licensee provides to the consumer immediately upon request.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.850 Requirements for privacy notice on website. (NRS 679B.130, 686A.025) A licensee who provides a notice on a website shall:
1. Design the notice to call attention to the nature and significance of the information contained in the notice.
2. Use text or visual cues to encourage a reader of the notice to scroll down the page to view the entire notice.
3. Ensure that other elements on the website, including, without limitation, text, graphics, hyperlinks or sound, do not distract the attention of the reader from the notice.
4. Place the notice or a direct link to the notice on a web page that consumers frequently access, including, without limitation, a web page used for transactions.
5. Label the direct link to a notice to convey the importance, nature and relevance of the notice.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.852 Sample clauses for use by licensees in complying with requirements for privacy notices. (NRS 679B.130, 686A.025)
1. Licensees, including, without limitation, a group of affiliates of a financial holding company that uses a common privacy notice, may use the sample clauses in this section for purposes of complying with the notices required pursuant to NAC 679B.800 to 679B.878, inclusive.
2. The sample clauses in this section are not exclusive. A licensee who uses a sample clause shall, to the extent applicable, be deemed to be in compliance with the requirements of NAC 679B.800 to 679B.878, inclusive.
3. To satisfy the requirements of NAC 679B.846 to describe the categories of nonpublic personal financial information the licensee collects, a licensee may use the following clause, which must be in substantially the following form:
We collect nonpublic personal financial information about you from the following sources:
Information we receive from you on applications or other forms;
Information about your transactions with us, our affiliates or others; and
Information we receive from a consumer reporting agency.
4. A licensee may use the clause in paragraph (a) or (b), as applicable, to satisfy the requirements of NAC 679B.846 to describe the categories of nonpublic personal financial information the licensee discloses. A licensee may use a clause in this subsection if the licensee discloses nonpublic personal financial information other than as permitted by the exceptions in NAC 679B.870, 679B.872 and 679B.874. The clause must be in substantially one of the following forms:
(a) We may disclose the following kinds of nonpublic personal financial information about you:
Information we receive from you on applications or other forms, such as (provide illustrative examples, such as “your name, address, social security number, assets, income and beneficiaries”);
Information about your transactions with us, our affiliates or others, such as (provide illustrative examples, such as “your policy coverage, premiums and payment history”); and
Information we receive from a consumer reporting agency, such as (provide illustrative examples, such as “your creditworthiness and credit history”).
(b) We may disclose all the information that we collect, as described (describe location in the notice, such as “above” or “below”).
5. A licensee may use the clause contained in this subsection, as applicable, to satisfy the requirements of NAC 679B.846 to describe the categories of nonpublic personal financial information about customers and former customers that the licensee discloses and the categories of affiliates and nonaffiliated third parties to whom the licensee discloses. A licensee may use the following clause if the licensee does not disclose nonpublic personal financial information to any party, other than as authorized by NAC 679B.872 and 679B.874. The clause must be in substantially the following form:
We do not disclose any nonpublic personal financial information about our customers or former customers to anyone, except as permitted by law.
6. A licensee may use the clause contained in this subsection, as applicable, to meet the requirement of NAC 679B.846 to describe the categories of affiliates and nonaffiliated third parties to whom the licensee discloses nonpublic personal financial information. The following clause may be used if the licensee discloses nonpublic personal financial information other than as authorized by NAC 679B.870, 679B.872 or 679B.874. The clause must be in substantially the following form:
We may disclose nonpublic personal financial information about you to the following types of third parties:
Financial service providers, such as (provide illustrative examples, such as “life insurers, automobile insurers, mortgage bankers, securities broker-dealers and insurance producers”);
Nonfinancial companies, such as (provide illustrative examples, such as “retailers, direct marketers, airlines and publishers”); and
Others, such as (provide illustrative examples, such as “nonprofit organizations”).
We may also disclose nonpublic personal financial information about you to nonaffiliated third parties as permitted by law.
7. A licensee may use the clause contained in paragraph (a) or (b), as applicable, to satisfy the requirements of NAC 679B.846 concerning the exception for service providers and joint marketers in NAC 679B.870. If a licensee discloses nonpublic personal financial information pursuant to the exception contained in NAC 679B.870, the licensee may describe the categories of nonpublic personal financial information the licensee discloses and the categories of third parties with which the licensee has contracted. The clause must be in substantially one of the following forms:
(a) We may disclose the following information to companies that perform marketing services on our behalf or to other financial institutions with which we have joint marketing agreements:
Information we receive from you on applications or other forms, such as (provide illustrative examples, such as: “your name, address, social security number, assets, income and beneficiaries”);
Information about your transactions with us, our affiliates or others, such as (provide illustrative examples, such as: “your policy coverage, premium, and payment history”); and
Information we receive from a consumer reporting agency, such as (provide illustrative examples, such as: “your creditworthiness and credit history”).
(b) We may disclose all the information we collect, as described (describe location in the notice, such as “above” or “below”) to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements.
8. A licensee may use the clause contained in this subsection, as applicable, to satisfy the requirement of NAC 679B.846 to provide an explanation of the right of a consumer to opt out of the disclosure of nonpublic personal financial information to nonaffiliated third parties, including, without limitation, the method by which the consumer may exercise that right. The licensee may use the following clause if the licensee discloses nonpublic personal financial information other than as authorized by NAC 679B.870, 679B.872 and 679B.874. The clause must be in substantially the following form:
If you prefer that we not disclose nonpublic personal financial information about you to nonaffiliated third parties, you may opt out of those disclosures, that is, you may direct us not to make those disclosures (other than disclosures permitted by law). If you wish to opt out of disclosures to nonaffiliated third parties, you may (describe a reasonable means of opting out, such as “call the following toll-free number: (insert number)”).
9. A licensee may use the following clause, as applicable, to satisfy the requirements of NAC 679B.846 to describe the policies and practices of the licensee for protecting the confidentiality and security of nonpublic personal financial information, which clause must be in substantially the following form:
We restrict access to nonpublic personal financial information about you to (provide an appropriate description, such as “those employees who need to know that information to provide products or services to you”). We maintain physical, electronic and procedural safeguards that comply with federal regulations to guard your nonpublic personal financial information.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.854 Circumstances under which licensee not subject to notice and opt-out requirements; compliance with requirements by surplus lines broker and surplus lines insurer. (NRS 679B.130, 686A.025)
1. A licensee is not subject to the notice and opt-out requirements for nonpublic personal financial information set forth in NAC 679B.800 to 679B.878, inclusive, if:
(a) The licensee is an employee, agent or other representative of a principal who is another licensee;
(b) The principal otherwise complies with the requirements of NAC 679B.800 to 679B.878, inclusive, by providing the required notices; and
(c) The licensee does not disclose any nonpublic personal financial information to any person other than the principal or any affiliates of the principal in a manner permitted by NAC 679B.800 to 679B.878, inclusive.
2. A surplus lines broker or surplus lines insurer shall be deemed to be in compliance with the notice and opt-out requirements for nonpublic personal financial information set forth in NAC 679B.800 to 679B.878, inclusive, if:
(a) Except as otherwise permitted by NAC 679B.872 or 679B.874, the broker or insurer does not disclose nonpublic personal financial information of a consumer or a customer to nonaffiliated third parties for any purpose, including, without limitation, joint servicing or marketing pursuant to NAC 679B.870; and
(b) The broker or insurer delivers a notice to the consumer at the time a customer relationship is established on which a notice in substantially the following form is printed in 16-point type:
Privacy Notice
The U.S. brokers that handled this insurance and the insurers that have underwritten this insurance will not disclose nonpublic personal financial information concerning the buyer to nonaffiliates of the brokers or insurers except as permitted by law.
3. For the purposes of this section, an employee, agent or other representative of a principal includes:
(a) An insurance producer, public adjuster or other licensee who is employed by another insurance producer, public adjuster or other licensee;
(b) An insurance producer of an insurer;
(c) An insurance producer that has binding authority for an insurer; or
(d) A sublicensee of a licensee, whether or not the sublicensee is licensed in any other capacity.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.856 Form of opt-out notice to consumers; opt-out methods. (NRS 679B.130, 686A.025)
1. If a licensee is required to provide an opt-out notice pursuant to NAC 679B.864, the notice must contain a clear and conspicuous notice that accurately explains the right to opt out. The notice must state:
(a) That the licensee discloses or reserves the right to disclose nonpublic personal financial information about the consumer to a nonaffiliated third party;
(b) That the consumer has the right to opt out of that disclosure; and
(c) A reasonable means by which the consumer may exercise the right to opt out.
2. A licensee provides adequate notice that the consumer may opt out of the disclosure of nonpublic personal financial information to a nonaffiliated third party if the licensee:
(a) Identifies all of the categories of nonpublic personal financial information that the licensee discloses or reserves the right to disclose;
(b) In the manner provided in NAC 679B.846, identifies all the categories of nonaffiliated third parties to which the licensee discloses the information;
(c) States that the consumer may opt out of the disclosure of the information; and
(d) Identifies the insurance products or services that the consumer obtains individually or jointly from the licensee to which an opt-out direction will apply.
3. A licensee provides a reasonable means to exercise the right to opt out by:
(a) Designating check-off boxes in a prominent location on the relevant forms with the opt-out notice;
(b) Including a reply form with the opt-out notice;
(c) If the consumer agrees to the electronic delivery of information, providing an electronic means to opt out, including a form that can be sent via electronic mail or processed at the website of the licensee; or
(d) Providing a toll-free telephone number that a consumer may call to opt out.
4. A licensee does not provide a reasonable means of opting out if:
(a) The only means of opting out is for the consumer to write his or her own letter to exercise that right; or
(b) The only means of opting out, as described in any notice subsequent to the initial notice, is to use a check-off box that the licensee provided with the initial notice, but did not include with the subsequent notice.
5. A licensee may require each consumer to use a specific means to opt out if the means of opting out is reasonable for that consumer.
6. A licensee may provide the opt-out notice together with or on the same written or electronic form as the initial notice that the licensee provides pursuant to NAC 679B.842.
7. If a licensee provides the opt-out notice later than required for the initial notice pursuant to NAC 679B.842, the licensee must also include a written copy or, if the consumer agrees, an electronic copy of the initial notice with the opt-out notice.
8. A licensee shall comply with the opt-out direction of a consumer as soon as reasonably practicable after receipt of the direction by the licensee.
9. A consumer may exercise the right to opt out at any time.
10. A direction of a consumer to opt out pursuant to this section or NAC 679B.858 is effective until the consumer revokes the direction in writing or, if the consumer agrees, electronically.
11. When a customer relationship terminates, the opt-out direction continues to apply to the nonpublic personal financial information that the licensee collected during or related to that customer relationship.
12. If the natural person subsequently establishes a new customer relationship with the licensee, the opt-out direction that applied to the former relationship does not apply to the new customer relationship.
13. When a licensee is required to deliver an opt-out notice pursuant to this section or NAC 679B.858, the licensee shall deliver the notice in the manner provided by NAC 679B.862.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.858 Form of opt-out notice to joint consumers; opt-out methods. (NRS 679B.130, 686A.025)
1. If two or more consumers jointly obtain an insurance product or service from a licensee, the licensee may provide a single opt-out notice.
2. In addition to the requirements of NAC 679B.856, an opt-out notice provided by a licensee must explain how the licensee will treat an opt-out direction by a joint consumer.
3. Any joint consumer may exercise the right to opt out. The licensee may:
(a) Treat an opt-out direction by a joint consumer as applying to all the associated joint consumers; or
(b) Permit each joint consumer to opt out separately.
4. If a licensee permits each joint consumer to opt out separately, the licensee shall permit one of the joint consumers to opt out on behalf of all the joint consumers.
5. A licensee may not require all joint consumers to opt out before implementing any opt-out direction.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.860 Revised privacy notices. (NRS 679B.130, 686A.025)
1. Except as otherwise provided in NAC 679B.800 to 679B.878, inclusive, a licensee shall not, directly or through an affiliate, disclose any nonpublic personal financial information about a consumer to a nonaffiliated third party other than a disclosure described in the initial notice that a licensee provides to a consumer pursuant to NAC 679B.842, unless:
(a) The licensee has provided the consumer with a clear and conspicuous revised notice that accurately describes the policies and practices of the licensee;
(b) The licensee has provided the consumer with a new opt-out notice;
(c) Before the licensee discloses the information to a nonaffiliated third party, the licensee has given the consumer a reasonable opportunity to opt out of the disclosure; and
(d) The consumer does not opt out.
2. Except as otherwise authorized by NAC 679B.870, 679B.872 and 679B.874, if a former customer has not had the opportunity to exercise an opt-out right, a licensee shall provide a revised notice to the former customer before disclosing:
(a) A new category of nonpublic personal financial information to any nonaffiliated third party;
(b) Nonpublic personal financial information to a new category of nonaffiliated third party; or
(c) Nonpublic personal financial information about a former customer to a nonaffiliated third party.
3. A revised notice is not required if a licensee discloses nonpublic personal financial information to a new nonaffiliated third party that the licensee adequately described in a prior notice.
4. If a licensee is required to deliver a revised privacy notice pursuant to this section, the licensee shall deliver the notice in the manner provided in NAC 679B.862.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.862 Delivery of notices. (NRS 679B.130, 686A.025)
1. A licensee shall deliver any notice required pursuant to NAC 679B.800 to 679B.878, inclusive, so that a consumer can reasonably be expected to receive actual notice in writing or, if the consumer agrees, electronically.
2. A licensee may reasonably expect that a consumer will receive actual notice if the licensee:
(a) Hand-delivers a printed copy of the notice to the consumer;
(b) Mails a printed copy of the notice separately, or with a policy, bill or other written communication, to the last known address of the consumer;
(c) For a consumer who conducts transactions electronically, posts the notice electronically and requires the consumer to acknowledge receipt of the notice as a necessary step to obtaining a particular insurance product or service; or
(d) For an isolated transaction with a consumer, posts the notice and requires the consumer to acknowledge receipt of the notice as a necessary step to obtaining the particular insurance product or service.
3. A licensee may not reasonably expect that a consumer will receive actual notice of the privacy policies and practices if the licensee:
(a) Only posts a notice in the office of the licensee;
(b) Only publishes a general advertisement of the privacy policies and practices of the licensee; or
(c) Sends the notice via electronic mail to a consumer who does not obtain an insurance product or service from the licensee electronically.
4. A licensee may reasonably expect that a customer will receive actual notice of the annual privacy notice of the licensee if:
(a) The customer uses the website of the licensee to access insurance products and services electronically and agrees to receive notices at the website, and the licensee continuously posts a current privacy notice in a clear and conspicuous manner on the website; or
(b) The customer has requested that the licensee refrain from sending any information regarding the customer relationship, and the current privacy notice of the licensee remains available to the customer upon request.
5. A licensee may not provide any notice required pursuant to NAC 679B.800 to 679B.878, inclusive, solely by oral means, whether in person or by telephone.
6. A licensee shall provide customers with the following notices in a manner that allows a customer to retain or later obtain the notice in writing or, if the customer agrees, electronically:
(a) The initial notice required pursuant to NAC 679B.842;
(b) The annual notice required pursuant to NAC 679B.844; and
(c) The revised notice required pursuant to NAC 679B.860, if any.
7. A licensee provides a privacy notice to the customer that the customer may retain or obtain later if the licensee:
(a) Hand-delivers a printed copy of the notice to the customer;
(b) Mails a printed copy of the notice to the last known address of the customer; or
(c) Makes the current privacy notice of the licensee available on a website or a link to another website for a customer who:
(1) Obtains an insurance product or service electronically; and
(2) Agrees to receive the notice at the website.
8. A licensee may provide a joint notice from the licensee and one or more affiliates or other financial institutions as identified in the notice if the notice is accurate with respect to the licensee and the other institutions. A licensee may also provide a notice on behalf of another financial institution.
9. If two or more consumers jointly obtain an insurance product or service from a licensee, the licensee may satisfy the initial, annual and revised notice requirements of NAC 679B.842, 679B.844 and 679B.860, respectively, by providing one notice to those consumers jointly.
10. For purposes of this section, an isolated transaction with a consumer includes, without limitation, a licensee providing an insurance quote or selling travel insurance to a consumer.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
Limitations on Disclosure of Certain Financial Information
NAC 679B.864 Disclosure of information to nonaffiliated third parties. (NRS 679B.130, 686A.025)
1. Except as otherwise provided in this regulation, a licensee may not, directly or through an affiliate, disclose any nonpublic personal financial information about a consumer to a nonaffiliated third party unless:
(a) The licensee has provided the consumer with an initial notice pursuant to NAC 679B.842;
(b) The licensee has provided the consumer with an opt-out notice pursuant to NAC 679B.856;
(c) The licensee has given the consumer a reasonable opportunity, before the licensee discloses the information to the nonaffiliated third party, to opt out of the disclosure; and
(d) The consumer does not opt out.
2. A licensee provides a consumer with a reasonable opportunity to opt out if:
(a) The licensee mails the notices required by this subsection to the consumer and allows the consumer to opt out by:
(1) Mailing an opt-out form;
(2) Calling a toll-free telephone number; or
(3) Any other reasonable means within 30 days from the date the licensee mails the notices.
(b) The customer opens an on-line account with a licensee and agrees to receive the notices electronically, and the licensee allows the customer to opt out by any reasonable means within 30 days after the date that the customer acknowledges receipt of the notices in conjunction with opening the account.
(c) For an isolated transaction, including, without limitation, providing the consumer with an insurance quote, the licensee provides the notices required by this section at the time of the transaction and requests that the consumer decide, as a necessary part of the transaction, whether or not to opt out before completing the transaction.
3. A licensee shall comply with this section, whether or not the licensee and the consumer have established a customer relationship.
4. Until a licensee complies with this section, a licensee shall not, directly or through any affiliate, disclose any nonpublic personal financial information about a consumer that the licensee has collected, whether or not the licensee collected the information before or after receiving the direction to opt out from the consumer.
5. A licensee may allow a consumer to select certain nonpublic personal financial information or certain nonaffiliated third parties with respect to which the consumer wishes to opt out.
6. For the purposes of this section, “opt out” means instructions from a consumer to a licensee to not disclose nonpublic personal financial information about that consumer to a nonaffiliated third party, except as otherwise provided in NAC 679B.870, 679B.872 and 679B.874.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.866 Redisclosure and reuse of information. (NRS 679B.130, 686A.025)
1. If a licensee receives nonpublic personal financial information from a nonaffiliated financial institution pursuant to NAC 679B.872 or 679B.874, the licensee may:
(a) Disclose the information to the affiliates of the financial institution from which the licensee received the information;
(b) Disclose the information to affiliates of the licensee who may disclose and use the information only to the extent that the licensee may disclose and use the information; and
(c) Disclose and use the information pursuant to NAC 679B.872 or 679B.874 in the ordinary course of business to carry out the activity covered by the exception pursuant to which the licensee received the information.
2. If a licensee receives information from a nonaffiliated financial institution for purposes of claims settlement, the licensee may disclose the information for fraud prevention or in response to a properly authorized subpoena. The licensee may not disclose the information to a third party for marketing purposes or use that information for its own marketing purposes.
3. If a licensee receives nonpublic personal financial information from a nonaffiliated financial institution other than information disclosed pursuant to NAC 679B.872 or 679B.874, the licensee may disclose the information:
(a) To the affiliates of the financial institution from which the licensee received the information;
(b) To the affiliates of the licensee who may disclose the information to the extent that the licensee is authorized to disclose such information; or
(c) To any other person, if the disclosure would be lawful if made directly to that person by the financial institution from which the licensee received the information.
4. In addition to any applicable exceptions provided in NAC 679B.872 and 679B.874, if a licensee obtains a customer list from a nonaffiliated financial institution:
(a) The licensee may use the list for its own purposes; and
(b) The licensee may disclose the list to another nonaffiliated third party only if the financial institution from which the licensee purchased the list could have lawfully disclosed the list to the third party.
5. A list disclosed pursuant to subsection 4 must be disclosed by a licensee in compliance with:
(a) The privacy policy of the financial institution from which the licensee received the list;
(b) The opt-out direction of each consumer whose nonpublic personal financial information the licensee intends to disclose; and
(c) The exceptions regarding disclosure in NAC 679B.872 or 679B.874.
6. If a licensee discloses nonpublic personal financial information to a nonaffiliated third party pursuant to an exception in NAC 679B.872 or 679B.874, the third party may disclose the information:
(a) To the affiliates of the licensee;
(b) To the affiliates of the third party who may disclose and use the information only to the extent that the third party may disclose and use the information; and
(c) In the ordinary course of business to carry out the activity covered by an exception contained in NAC 679B.872 or 679B.874.
7. If a licensee discloses nonpublic personal financial information to a nonaffiliated third party other than pursuant to an exception contained in NAC 679B.872 or 679B.874, the third party may disclose the information only:
(a) To the affiliates of a licensee;
(b) To the affiliates of the third party who may disclose the information only to the extent the third party can disclose the information; and
(c) To any other person, if such disclosure would be lawful if the licensee made the disclosure directly to that person.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.868 Disclosure of policy number or similar form of access number or access code for policy or transaction account for marketing purposes. (NRS 679B.130, 686A.025)
1. Except as otherwise provided in subsection 2, a licensee shall not, directly or through an affiliate, disclose, other than to a consumer reporting agency, a policy number or similar form of access number or access code for the policy or transaction account of a consumer to any nonaffiliated third party for use in:
(a) Telemarketing;
(b) Direct mail marketing; or
(c) Marketing through electronic mail to the consumer.
2. The provisions of subsection 1 do not apply if a licensee discloses a policy number, or similar access number or access code, to:
(a) A service provider of the licensee solely in order to perform the marketing of products or services of the licensee, as long as the service provider is not authorized to initiate directly charges to the account;
(b) A licensee who is a producer solely to perform marketing for the products or services of the licensee; or
(c) A participant in an affinity program or similar program where the participants in the program are identified to the customer when the customer enters into the program.
3. For the purposes of this section, a policy number, or similar form of access number or access code does not include a number or code in an encrypted form if the licensee does not provide the recipient with a means to decode the number or code.
4. For the purposes of this section:
(a) A policy or transaction account is an account other than a deposit account or a credit card account.
(b) A policy or transaction account does not include an account to which third parties cannot initiate charges.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
Exceptions to Limitations on Disclosure of Certain Financial Information
NAC 679B.870 Exceptions to opt-out requirements for disclosure of information for service providers and joint marketing. (NRS 679B.130, 686A.025)
1. The opt-out requirements in NAC 679B.856 and 679B.864 do not apply when a licensee provides nonpublic personal financial information to a nonaffiliated third party to perform services for the licensee or functions on behalf of the licensee, if the licensee:
(a) Provides the initial notice in accordance with NAC 679B.842; and
(b) Enters into a joint agreement with the third party that prohibits the third party from disclosing or using the information other than to carry out the purposes for which the licensee disclosed the information, including use pursuant to an exception in NAC 679B.872 or 679B.874 in the ordinary course of business to carry out those purposes.
2. If a licensee discloses nonpublic personal financial information pursuant to this section to a financial institution with which the licensee performs joint marketing, the joint agreement of the licensee with the institution satisfies the requirements of subsection 1 if the joint agreement prohibits the institution from disclosing or using the nonpublic personal financial information other than disclosure of information:
(a) Necessary to carry out joint marketing; or
(b) Pursuant to an exception in NAC 679B.872 or 679B.874, in the ordinary course of business to carry out joint marketing.
3. The services a nonaffiliated third party performs for a licensee pursuant to subsection 1 of this section may include marketing of:
(a) The products or services of the licensee; or
(b) Financial products or services offered pursuant to a joint agreement between the licensee and one or more financial institutions.
4. For the purposes of this section:
(a) “Financial product or service” means any product or service that a financial holding company could offer by engaging in an activity that is financial in nature or incidental to such a financial activity pursuant to 12 U.S.C. § 1843(k) of the Bank Holding Company Act of 1956. The term includes an evaluation or brokerage of information that a financial institution collects in connection with a request or an application from a consumer for a financial product or service.
(b) “Joint agreement” means a written contract pursuant to which a licensee and one or more financial institutions jointly offer, endorse or sponsor a financial product or service.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.872 Exceptions to notice and opt-out requirements for disclosure of information for processing and servicing transactions. (NRS 679B.130, 686A.025)
1. The requirements for initial notice pursuant to NAC 679B.842, the opt-out notice pursuant to NAC 679B.856 and 679B.864, and the requirements applicable to service providers and joint marketing in NAC 679B.870 do not apply:
(a) If the licensee discloses nonpublic personal financial information necessary to effect, administer or enforce a transaction that a consumer requests or authorizes; or
(b) In connection with:
(1) Servicing or processing an insurance product or service that a consumer requests or authorizes;
(2) Maintaining or servicing the account of a consumer with a licensee, or with another entity as part of a program involving a private label credit card or other extension of credit on behalf of such an entity;
(3) A proposed or actual securitization, a secondary market sale, including sales of servicing rights, or a similar transaction related to a transaction of the consumer;
(4) Reinsurance, stop loss insurance or excess loss insurance; or
(5) Informing a policyholder, or the producer or broker of a policyholder, regarding a claim asserted by or paid to a consumer pursuant to a policy, including the servicing or processing of such a claim.
2. For the purposes of this section, “necessary to effect, administer or enforce a transaction” means that a disclosure is:
(a) Required to enforce the rights of a licensee or the rights of other persons engaged in carrying out the financial transaction or providing the product or service;
(b) One of the lawful or appropriate methods to enforce the rights of a licensee or the rights of other persons engaged in carrying out the financial transaction or providing the product or service; or
(c) Required, or is a usual, appropriate or acceptable method:
(1) To carry out the transaction or the product or service business of which the transaction is a part, and to record, service or maintain the account of the consumer in the ordinary course of providing the insurance product or service;
(2) To administer or service benefits or claims relating to the transaction or the product or service business of which it is a part;
(3) To provide a confirmation, statement or other record of the transaction, or information on the status or value of the insurance product or service to the consumer or the agent or producer of the consumer;
(4) To accrue or recognize incentives or bonuses associated with the transaction that are provided by a licensee or any other party;
(5) To underwrite insurance at the request of a consumer or for any of the following purposes as they relate to insurance of a consumer:
(I) Account administration;
(II) Reporting;
(III) Investigating or preventing fraud;
(IV) Investigating or preventing material misrepresentation;
(V) Processing premium payments;
(VI) Processing insurance claims; or
(VII) Administering insurance benefits, including, without limitation, utilization review activities, participating in research projects, or as otherwise required or specifically permitted by federal or state law; or
(6) In connection with:
(I) The authorization, settlement, billing, processing, clearing, transferring, reconciling or collection of amounts charged, debited or otherwise paid using a debit, credit or other payment card, check or account number, or by other payment means;
(II) The transfer of receivables, accounts or interests therein; or
(III) The audit of debit, credit or other payment information.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.874 Other exceptions to notice and opt-out requirements for disclosure of information. (NRS 679B.130, 686A.025)
1. The provisions of NAC 679B.856, 679B.864 and 679B.870 do not apply to a licensee who discloses nonpublic personal financial information:
(a) With the consent or at the direction of the consumer, if the consumer has not revoked the consent or direction;
(b) To protect the confidentiality or security of records of a licensee pertaining to the consumer, service, product or transaction;
(c) To prevent or protect against actual or potential fraud or unauthorized transactions;
(d) For required risk control of an institution, or for resolving consumer disputes or inquiries;
(e) To a person holding a legal or beneficial interest relating to the consumer;
(f) To a person acting in a fiduciary or representative capacity on behalf of the consumer;
(g) To provide information to a rate advisory organization;
(h) To provide information to a guaranty fund or agency;
(i) To provide information to an agency that is rating a licensee;
(j) To provide information to a person who is assessing the compliance of the licensee with industry standards;
(k) To provide information to the attorneys, accountants and auditors of the licensee;
(l) To the extent specifically permitted or required pursuant to other provisions of law;
(m) In accordance with the Right to Financial Privacy Act of 1978, 12 U.S.C. §§ 3401 et seq.;
(n) To a law enforcement agency for an investigation of a matter related to public safety;
(o) To a consumer reporting agency in accordance with the Fair Credit Reporting Act, 15 U.S.C. §§ 1681 et seq.;
(p) From a consumer report that has been reported by a consumer reporting agency;
(q) In connection with a proposed or actual sale, merger, transfer or exchange of all or a portion of a business or operating unit if the disclosure of nonpublic personal financial information concerns solely consumers of the business or unit;
(r) To comply with federal, state or local laws;
(s) To comply with a properly authorized civil, criminal or regulatory investigation;
(t) To comply with a properly authorized subpoena or summons from federal, state or local authorities;
(u) To respond to judicial process or governmental regulatory authorities having jurisdiction over a licensee for examination, compliance or other similar purposes authorized by law;
(v) For purposes related to the replacement of a workers’ compensation policy; or
(w) In compliance with 12 U.S.C. §§ 1951 et seq. and 31 U.S.C. §§ 5311 et seq., to:
(1) A state insurance authority;
(2) The Federal Trade Commission;
(3) The Board of Governors of the Federal Reserve System;
(4) The Office of the Comptroller of the Currency;
(5) The Federal Deposit Insurance Corporation;
(6) The Office of Thrift Supervision;
(7) The National Credit Union Administration;
(8) The Securities and Exchange Commission;
(9) The Secretary of the Treasury; or
(10) Other self-regulatory organizations.
2. A consumer may revoke his or her consent to disclosure by subsequently exercising the right to opt out of future disclosures of nonpublic personal financial information in the manner provided in NAC 679B.856.
3. A licensee placed into receivership or liquidation is exempt from the notice requirements in NAC 679B.800 to 679B.878, inclusive. During the receivership or liquidation, the licensee shall not disclose any nonpublic personal financial information about customers or former customers except as otherwise authorized by law.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
Miscellaneous Provisions
NAC 679B.876 Discrimination prohibited. (NRS 679B.130, 686A.025) A licensee shall not unfairly discriminate against any consumer or customer because the consumer or customer has opted out from the disclosure of nonpublic personal financial information pursuant to NAC 679B.800 to 679B.878, inclusive.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)
NAC 679B.878 Failure to comply with requirements regarding notices and disclosures. (NRS 679B.130, 686A.025, 686A.170) Failure to comply with the requirements of NAC 679B.800 to 679B.878, inclusive, regarding notices and disclosures constitutes an undefined unfair trade practice pursuant to NRS 686A.170.
(Added to NAC by Comm’r of Insurance by R130-01, eff. 12-17-2002)