Senate Bill No. 319–Senator Shaffer

 

CHAPTER..........

 

AN ACT relating to insurance; restricting the use by an insurer of information included in the consumer credit report of an applicant or policyholder as a basis for making certain determinations and taking certain actions regarding policies of insurance, and providing for related procedures, duties, restrictions and exceptions; revising the membership of certain boards; providing that any refund of an assessment by the Division of Industrial Relations of the Department of Business and Industry must include payment for interest earned; providing that hearing officers and appeals officers shall designate the location of certain hearings; requiring the Commissioner of Insurance to conduct a study relating to the Investments of Insurers Model Act adopted by the National Association of Insurance Commissioners; requiring the Commissioner to prepare and submit to the Governor and
the Legislature a report concerning certain matters relating to the use of credit information in making decisions related to insurance
; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1  Section 1. (Deleted by amendment.)

1-2  Sec. 1.5.  Chapter 686A of NRS is hereby amended by adding

1-3  thereto the provisions set forth as sections 2 to 15, inclusive, of this

1-4  act.

1-5  Sec. 2.  As used in sections 2 to 15, inclusive, of this act,

1-6  unless the context otherwise requires, the words and terms defined

1-7  in sections 3 to 8, inclusive, of this act have the meanings ascribed

1-8  to them in those sections.

1-9  Sec. 3.  “Adverse action” means a denial or cancellation of,

1-10  an increase in any charge for, or a reduction or other adverse or

1-11  unfavorable change in the terms of coverage or amount of, any

1-12  insurance, existing or applied for, in connection with any policy.

1-13      Sec. 4.  “Affiliate” means any company that controls, is

1-14  controlled by, or is under common control with another company.

1-15      Sec. 5.  “Consumer credit report” means any written, oral or

1-16  other communication of information by a consumer reporting

1-17  agency bearing on the credit worthiness, credit standing or credit

1-18  capacity of an applicant or policyholder, and which is used or

1-19  expected to be used or collected in whole or in part for the purpose

1-20  of serving as a factor to determine:

1-21      1.  Whether to issue, cancel or renew a policy; or


2-1  2.  The amount of the premium for a policy.

2-2  Sec. 6.  “Consumer reporting agency” means any person

2-3  which, for monetary fees, dues, or on a cooperative nonprofit

2-4  basis, regularly engages in whole or in part in the practice of

2-5  assembling or evaluating consumer credit information or other

2-6  information on consumers for the purpose of furnishing consumer

2-7  credit reports to third parties.

2-8  Sec. 7.  “Credit information” means any information that is

2-9  related to credit and derived from a consumer credit report, found

2-10  on a consumer credit report or provided on an application for a

2-11  policy. The term does not include information that is not related to

2-12  credit, regardless of whether it is contained in a consumer credit

2-13  report or in an application for a policy, or is used to calculate an

2-14  insurance score.

2-15      Sec. 8.  “Insurance score” means a number or rating that is

2-16  derived from an algorithm, computer application, model or other

2-17  process that is based in whole or in part on credit information for

2-18  the purposes of predicting the future losses or exposure with

2-19  regard to an applicant or policyholder.

2-20      Sec. 9.  The provisions of sections 2 to 15, inclusive, of this

2-21  act do not apply to a contract of surety insurance issued pursuant

2-22  to chapter 691B of NRS or any commercial or business policy.

2-23      Sec. 10.  An insurer that uses information from a consumer

2-24  credit report shall not:

2-25      1.  Use an insurance score that is calculated using income,

2-26  gender, address, zip code, ethnic group, religion, marital status or

2-27  nationality of the consumer as a factor, or would otherwise lead to

2-28  unfair or invidious discrimination.

2-29      2.  Deny, cancel or fail to renew a policy on the basis of credit

2-30  information unless the insurer also considers other applicable

2-31  underwriting factors that are independent of credit information

2-32  and not expressly prohibited by this section.

2-33      3.  Base renewal rates for a policy upon credit information

2-34  unless the insurer also considers other applicable factors

2-35  independent of credit information.

2-36      4.  Take an adverse action against an applicant or

2-37  policyholder based on the applicant or policyholder not having a

2-38  credit card account unless the insurer also considers other

2-39  applicable factors independent of credit information.

2-40      5.  Consider an absence of credit information or an inability

2-41  to calculate an insurance score in underwriting or rating a policy

2-42  unless the insurer does any one of the following:

2-43      (a) Treats the applicant or policyholder as otherwise approved

2-44  by the Commissioner, after the insurer presents to the

2-45  Commissioner information indicating that such an absence or

2-46  inability relates to the risk for the insurer.


3-1  (b) Treats the applicant or policyholder as if the applicant or

3-2  policyholder had neutral credit information, as defined by the

3-3  insurer.

3-4  (c) Excludes the use of credit information as a factor, and uses

3-5  only underwriting criteria other than credit information.

3-6  6.  Take an adverse action against an applicant or

3-7  policyholder based on credit information, unless an insurer

3-8  obtains and uses a consumer credit report issued or an insurance

3-9  score calculated within 90 days from the date the policy is first

3-10  written or renewal is issued.

3-11      7.  Except as otherwise provided in this subsection, use credit

3-12  information regarding a policyholder without obtaining an

3-13  updated consumer credit report regarding the policyholder and

3-14  recalculating the insurance score at least once every 36 months.

3-15  At the time of the annual renewal of a policyholder’s policy, the

3-16  insurer shall, upon the request of the policyholder or the

3-17  policyholder’s agent, reunderwrite and rerate the policy based

3-18  upon a current consumer credit report or insurance score. An

3-19  insurer need not, at the request of a policyholder or the

3-20  policyholder’s agent, recalculate the insurance score of or obtain

3-21  an updated consumer credit report of the policyholder more

3-22  frequently than once in any 12-month period. An insurer may, at

3-23  its discretion, obtain an updated consumer credit report regarding

3-24  a policyholder more frequently than once every 36 months, if to do

3-25  so is consistent with the underwriting guidelines of the insurer. An

3-26  insurer does not need to obtain an updated consumer credit report

3-27  for a policyholder if any one of the following applies:

3-28      (a) The insurer is treating the policyholder as otherwise

3-29  approved by the Commissioner.

3-30      (b) The policyholder is in the most favorably-priced tier of the

3-31  insurer and all affiliates of the insurer. With respect to such a

3-32  policyholder, the insurer may elect to obtain an updated consumer

3-33  credit report if to do so is consistent with the underwriting

3-34  guidelines of the insurer.

3-35      (c) Credit information was not used for underwriting or rating

3-36  the policyholder when the policy was initially written. The fact that

3-37  credit information was not used initially does not preclude an

3-38  insurer from using such information subsequently when

3-39  underwriting or rating such a policyholder upon renewal, if to do

3-40  so is consistent with the underwriting guidelines of the insurer.

3-41      (d) The insurer reevaluates the policyholder at least once every

3-42  36 months based upon underwriting or rating factors other than

3-43  credit information.

3-44      8.  Use the following as a negative factor in any insurance

3-45  scoring methodology or in reviewing credit information for the

3-46  purpose of underwriting or rating a policy:


4-1  (a) Credit inquiries not initiated by the applicant or

4-2  policyholder, or inquiries requested by the applicant or

4-3  policyholder for his or her own credit information.

4-4  (b) Inquiries relating to insurance coverage, if so identified on

4-5  the consumer credit report.

4-6  (c) Collection accounts relating to medical treatment, if so

4-7  identified on the consumer credit report.

4-8  (d) Multiple lender inquiries, if identified on the consumer

4-9  credit report as being related to home loans or mortgages and

4-10  made within 30 days of one another, unless only one inquiry is

4-11  considered.

4-12      (e) Multiple lender inquiries, if identified on the consumer

4-13  credit report as being related to a loan for an automobile and

4-14  made within 30 days of one another, unless only one inquiry is

4-15  considered.

4-16      Sec. 11.  If it is determined pursuant to the dispute resolution

4-17  process set forth in section 611(a) of the federal Fair Credit

4-18  Reporting Act, 15 U.S.C. § 1681i(a), that the credit information of

4-19  a policyholder was incorrect or incomplete and if the insurer

4-20  receives notice of such determination from either the consumer

4-21  reporting agency or from the policyholder, the insurer shall

4-22  reunderwrite and rerate the policyholder within 30 days of

4-23  receiving the notice. After reunderwriting or rerating the insured,

4-24  the insurer shall make any adjustments necessary, consistent with

4-25  its underwriting and rating guidelines. If an insurer determines

4-26  that the policyholder has overpaid a premium, the insurer shall

4-27  refund to the policyholder the amount of overpayment calculated

4-28  back to the shorter of either the last 12 months of coverage or the

4-29  actual period of the policy.

4-30      Sec. 12. 1.  If an insurer uses credit information in

4-31  underwriting or rating an applicant, the insurer or its agent shall

4-32  disclose, either on the application for the policy or at the time the

4-33  application is taken, that the insurer may obtain credit

4-34  information in connection with the application. The disclosure

4-35  must be written or provided to an applicant in the same medium as

4-36  the application. The insurer need not provide the disclosure

4-37  required pursuant to this section to a policyholder upon renewal of

4-38  a policy if the policyholder was previously provided the disclosure

4-39  in connection with the policy.

4-40      2.  An insurer may comply with the requirements of this

4-41  section by providing the following statement:

 

4-42  In connection with this application for insurance, we may

4-43  review your credit report or obtain or use a credit-based

4-44  insurance score based on the information contained in that


5-1  credit report. We may use a third party in connection with

5-2  the development of your insurance score.

5-3  Sec. 13. If an insurer takes an adverse action based upon

5-4  credit information, the insurer shall:

5-5  1.  Provide notice to the applicant or policyholder that an

5-6  adverse action has been taken, in accordance with the

5-7  requirements of section 615(a) of the federal Fair Credit

5-8  Reporting Act, 15 U.S.C. § 1681m(a).

5-9  2.  Provide notice to the applicant or policyholder explaining

5-10  the reasons for the adverse action. The reasons must be provided

5-11  in sufficiently clear and specific language so that a person can

5-12  identify the basis for the insurer’s decision to take the adverse

5-13  action. The notice must include a description of not more than

5-14  four factors that were the primary influences of the adverse

5-15  action. The use of generalized terms such as “poor credit history,”

5-16  “poor credit rating” or “poor insurance score” does not meet the

5-17  requirements of this subsection. Standardized explanations

5-18  provided by consumer reporting agencies are deemed to cGreen numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).omply

5-19  with this section.

5-20      Sec. 14.  1.  An insurer shall indemnify, defend and hold

5-21  harmless an agent of the insurer from and against all liability, fees

5-22  and costs arising out of or relating to the actions, errors or

5-23  omissions of the agent with regard to obtaining or using credit

5-24  information or insurance scores for the insurer, if the agent

5-25  follows the instructions of or procedures established by the insurer

5-26  and complies with any applicable law or regulation.

5-27      2.  This section does not provide, expand, limit or prohibit any

5-28  cause of action an applicant or policyholder may have against an

5-29  agent of an insurer.

5-30      Sec. 15. 1.  A consumer reporting agency shall not provide

5-31  or sell data or lists that include any information that in whole or

5-32  in part was submitted in conjunction with:

5-33      (a) An inquiry by or for an insurer about the credit

5-34  information of an applicant or policyholder; or

5-35      (b) A request for a credit report or insurance score.

5-36      2.  The information described in subsection 1 includes,

5-37  without limitation:

5-38      (a) The expiration date of a policy or any other information

5-39  that may identify time periods during which a policy of an

5-40  applicant or policyholder may expire; and

5-41      (b) The terms and conditions of the coverage provided by a

5-42  policy of an applicant or policyholder.

5-43      3.  The restriction set forth in subsection 1 does not apply to

5-44  data or lists the consumer reporting agency supplies to the insurer,

5-45  or an agent or affiliate of the insurer, from whom the information

5-46  was received.


6-1  4.  The provisions of this section do not restrict any insurer

6-2  from being able to obtain a report regarding a motor vehicle or a

6-3  report of a history of claims.

6-4  Sec. 16.  NRS 686C.140 is hereby amended to read as follows:

6-5  686C.140  1.  The Board of Directors of the Association

6-6  consists of not less than five nor more than nine members, serving

6-7  terms as established in the plan of operation.

6-8  2.  The members of the Board who represent insurers must be

6-9  selected by member insurers subject to the approval of the

6-10  Commissioner. If practicable, one of the members of the Board

6-11  must be an officer of a domestic insurer.

6-12      3.  Two public representatives must be appointed to the Board

6-13  by the Commissioner. A public representative may not be an officer,

6-14  director or employee of an insurer or engaged in the business of

6-15  insurance.

6-16      4.  Vacancies on the Board must be filled for the remaining

6-17  period of the term by majority vote of the members of the Board,

6-18  subject to the approval of the Commissioner, for members who

6-19  represent insurers, and by the Commissioner for public

6-20  representatives.

6-21      5.  To select the initial Board of Directors, and initially organize

6-22  the Association, the Commissioner shall give notice to all member

6-23  insurers of the time and place of the organizational meeting. In

6-24  determining voting rights at the organizational meeting, each

6-25  member insurer is entitled to one vote in person or by proxy. If the

6-26  Board of Directors is not selected within 60 days after notice of the

6-27  organizational meeting, the Commissioner may appoint the initial

6-28  members to represent insurers in addition to the public

6-29  representatives.

6-30      [2.] 6.  In approving selections or in appointing members to the

6-31  Board, the Commissioner shall consider, among other things,

6-32  whether all member insurers are fairly represented.

6-33      [3.] 7.  Members of the Board may be reimbursed from the

6-34  assets of the Association for expenses incurred by them as members

6-35  of the Board of Directors but members of the Board may not

6-36  otherwise be compensated by the Association for their services.

6-37      Sec. 17.  NRS 687A.050 is hereby amended to read as follows:

6-38      687A.050  1.  The Board of Directors of the Association shall

6-39  consist of not fewer than five nor more than nine persons. The

6-40  members of the Board shall be appointed by the Commissioner and

6-41  shall serve at his discretion. Vacancies on the Board shall be filled

6-42  in the same manner as initial appointments.

6-43      2.  A majority of the members appointed shall be the designated

6-44  representatives of member insurers. If practicable, one of the

6-45  members appointed as a designated representative of the member

6-46  insurers must be an officer of a domestic insurer. The


7-1  Commissioner shall consider among other things whether all

7-2  member insurers are fairly represented.

7-3  3.  Members of the Board may be reimbursed from the assets of

7-4  the Association for expenses incurred by them as members of the

7-5  Board of Directors.

7-6  Sec. 18.  Chapter 687B of NRS is hereby amended by adding

7-7  thereto a new section to read as follows:

7-8  Unless otherwise provided by a specific statue, if a signature is

7-9  required of any person, the person may provide as the signature of

7-10  the person:

7-11      1.  An original signature;

7-12      2.  A facsimile signature; or

7-13      3.  An electronic signature pursuant to the provisions of

7-14  chapter 719 of NRS.

7-15      Sec. 19.  NRS 687B.160 is hereby amended to read as follows:

7-16      687B.160  1.  Every insurance policy must be executed in the

7-17  name of and on behalf of the insurer by its officer, attorney in fact,

7-18  employee or representative duly authorized by the insurer.

7-19      2.  [A facsimile signature of any] Any such executing individual

7-20  may [be used] use, in lieu of an original signature[.] :

7-21      (a) A facsimile signature; or

7-22      (b) An electronic signature pursuant to the provisions of

7-23  chapter 719 of NRS.

7-24      3.  An insurance contract issued before, on or after January 1,

7-25  1972, which is otherwise valid is not rendered invalid by reason of

7-26  the apparent execution thereof on behalf of the insurer by the

7-27  imprinted facsimile signature of an individual not authorized so to

7-28  execute as of the date of the policy.

7-29      Sec. 20.  NRS 232.680 is hereby amended to read as follows:

7-30      232.680  1.  The cost of carrying out the provisions of NRS

7-31  232.550 to 232.700, inclusive, and of supporting the Division, a

7-32  full-time employee of the Legislative Counsel Bureau and the Fraud

7-33  Control Unit for Industrial Insurance established pursuant to NRS

7-34  228.420, and that portion of the cost of the Office for Consumer

7-35  Health Assistance established pursuant to NRS 223.550 that is

7-36  related to providing assistance to consumers and injured employees

7-37  concerning workers’ compensation, must be paid from assessments

7-38  payable by each insurer, including each employer who provides

7-39  accident benefits for injured employees pursuant to NRS 616C.265.

7-40      2.  The Administrator shall assess each insurer, including each

7-41  employer who provides accident benefits for injured employees

7-42  pursuant to NRS 616C.265. To establish the amount of the

7-43  assessment, the Administrator shall determine the amount of money

7-44  necessary for each of the expenses set forth in subsections 1 and 4 of

7-45  this section and subsection 3 of NRS 616A.425 and determine the

7-46  amount that is payable by the private carriers, the self-insured


8-1  employers, the associations of self-insured public or private

8-2  employers and the employers who provide accident benefits

8-3  pursuant to NRS 616C.265 for each of the programs. For the

8-4  expenses from which more than one group of insurers receives

8-5  benefit, the Administrator shall allocate a portion of the amount

8-6  necessary for that expense to be payable by each of the relevant

8-7  group of insurers, based upon the expected annual expenditures for

8-8  claims of each group of insurers. After allocating the amounts

8-9  payable among each group of insurers for all the expenses from

8-10  which each group receives benefit, the Administrator shall apply an

8-11  assessment rate to the:

8-12      (a) Private carriers that reflects the relative hazard of the

8-13  employments covered by the private carriers, results in an equitable

8-14  distribution of costs among the private carriers and is based upon

8-15  expected annual premiums to be received;

8-16      (b) Self-insured employers that results in an equitable

8-17  distribution of costs among the self-insured employers and is based

8-18  upon expected annual expenditures for claims;

8-19      (c) Associations of self-insured public or private employers that

8-20  results in an equitable distribution of costs among the associations

8-21  of self-insured public or private employers and is based upon

8-22  expected annual expenditures for claims; and

8-23      (d) Employers who provide accident benefits pursuant to NRS

8-24  616C.265 that reflect the relative hazard of the employments

8-25  covered by those employers, results in an equitable distribution of

8-26  costs among the employers and is based upon expected annual

8-27  expenditures for claims.

8-28  The Administrator shall adopt regulations that establish the formula

8-29  for the assessment and for the administration of payment, and any

8-30  penalties that the Administrator determines are necessary to carry

8-31  out the provisions of this subsection. The formula may use actual

8-32  expenditures for claims. As used in this subsection, the term “group

8-33  of insurers” includes the group of employers who provide accident

8-34  benefits for injured employees pursuant to NRS 616C.265.

8-35      3.  Federal grants may partially defray the costs of the Division.

8-36      4.  Assessments made against insurers by the Division after the

8-37  adoption of regulations must be used to defray all costs and

8-38  expenses of administering the program of workers’ compensation,

8-39  including the payment of:

8-40      (a) All salaries and other expenses in administering the Division,

8-41  including the costs of the office and staff of the Administrator.

8-42      (b) All salaries and other expenses of administering NRS

8-43  616A.435 to 616A.460, inclusive, the offices of the Hearings

8-44  Division of the Department of Administration and the programs of

8-45  self-insurance and review of premium rates by the Commissioner of

8-46  Insurance.


9-1  (c) The salary and other expenses of a full-time employee of the

9-2  Legislative Counsel Bureau whose principal duties are limited to

9-3  conducting research and reviewing and evaluating data related to

9-4  industrial insurance.

9-5  (d) All salaries and other expenses of the Fraud Control Unit for

9-6  Industrial Insurance established pursuant to NRS 228.420.

9-7  (e) Claims against uninsured employers arising from compliance

9-8  with NRS 616C.220 and 617.401.

9-9  (f) That portion of the salaries and other expenses of the Office

9-10  for Consumer Health Assistance established pursuant to NRS

9-11  223.550 that is related to providing assistance to consumers and

9-12  injured employees concerning workers’ compensation.

9-13      5.  If the Division refunds any part of an assessment, the

9-14  Division shall include in that refund any interest earned by the

9-15  Division from the refunded part of the assessment.

9-16      Sec. 21.  NRS 616A.425 is hereby amended to read as follows:

9-17      616A.425  1.  There is hereby established in the State Treasury

9-18  the Fund for Workers’ Compensation and Safety as an enterprise

9-19  fund. All money received from assessments levied on insurers and

9-20  employers by the Administrator pursuant to NRS 232.680 must be

9-21  deposited in this Fund.

9-22      2.  All assessments, penalties, bonds, securities and all other

9-23  properties received, collected or acquired by the Division for

9-24  functions supported in whole or in part from the Fund must be

9-25  delivered to the custody of the State Treasurer for deposit to the

9-26  credit of the Fund.

9-27      3.  All money and securities in the Fund must be used to defray

9-28  all costs and expenses of administering the program of workmen’s

9-29  compensation, including the payment of:

9-30      (a) All salaries and other expenses in administering the Division

9-31  of Industrial Relations, including the costs of the office and staff of

9-32  the Administrator.

9-33      (b) All salaries and other expenses of administering NRS

9-34  616A.435 to 616A.460, inclusive, the offices of the Hearings

9-35  Division of the Department of Administration and the programs of

9-36  self-insurance and review of premium rates by the Commissioner.

9-37      (c) The salary and other expenses of a full-time employee of the

9-38  Legislative Counsel Bureau whose principal duties are limited to

9-39  conducting research and reviewing and evaluating data related to

9-40  industrial insurance.

9-41      (d) All salaries and other expenses of the Fraud Control Unit for

9-42  Industrial Insurance established pursuant to NRS 228.420.

9-43      (e) Claims against uninsured employers arising from compliance

9-44  with NRS 616C.220 and 617.401.

9-45      (f) That portion of the salaries and other expenses of the Office

9-46  for Consumer Health Assistance established pursuant to NRS


10-1  223.550 that is related to providing assistance to consumers and

10-2  injured employees concerning workers’ compensation.

10-3      4.  The State Treasurer may disburse money from the Fund only

10-4  upon written order of the Controller.

10-5      5.  The State Treasurer shall invest money of the Fund in the

10-6  same manner and in the same securities in which he is authorized to

10-7  invest state general funds which are in his custody. Income realized

10-8  from the investment of the assets of the Fund must be credited to the

10-9  Fund.

10-10     6.  The Commissioner shall assign an actuary to review the

10-11  establishment of assessment rates. The rates must be filed with the

10-12  Commissioner 30 days before their effective date. Any insurer or

10-13  employer who wishes to appeal the rate so filed must do so pursuant

10-14  to NRS 679B.310.

10-15     7.  If the Division refunds any part of an assessment, the

10-16  Division shall include in that refund any interest earned by the

10-17  Division from the refunded part of the assessment.

10-18     Sec. 22.  NRS 616C.330 is hereby amended to read as follows:

10-19     616C.330  1.  The hearing officer shall:

10-20     (a) Within 5 days after receiving a request for a hearing, set the

10-21  hearing for a date and time within 30 days after his receipt of the

10-22  request [.] at a place in Carson City, Nevada, or Las Vegas,

10-23  Nevada, or upon agreement of one or more of the parties to pay all

10-24  additional costs directly related to an alternative location, at any

10-25  other place of convenience to the parties, at the discretion of the

10-26  hearing officer;

10-27     (b) Give notice by mail or by personal service to all interested

10-28  parties to the hearing at least 15 days before the date and time

10-29  scheduled; and

10-30     (c) Conduct hearings expeditiously and informally.

10-31     2.  The notice must include a statement that the injured

10-32  employee may be represented by a private attorney or seek

10-33  assistance and advice from the Nevada Attorney for Injured

10-34  Workers.

10-35     3.  If necessary to resolve a medical question concerning an

10-36  injured employee’s condition or to determine the necessity of

10-37  treatment for which authorization for payment has been denied, the

10-38  hearing officer may refer the employee to a physician or

10-39  chiropractor of his choice who has demonstrated special competence

10-40  to treat the particular medical condition of the employee. If the

10-41  medical question concerns the rating of a permanent disability, the

10-42  hearing officer may refer the employee to a rating physician or

10-43  chiropractor. The rating physician or chiropractor must be selected

10-44  in rotation from the list of qualified physicians and chiropractors

10-45  maintained by the Administrator pursuant to subsection 2 of NRS

10-46  616C.490, unless the insurer and injured employee otherwise agree


11-1  to a rating physician or chiropractor. The insurer shall pay the costs

11-2  of any medical examination requested by the hearing officer.

11-3      4.  If an injured employee has requested payment for the cost of

11-4  obtaining a second determination of his percentage of disability

11-5  pursuant to NRS 616C.100, the hearing officer shall decide whether

11-6  the determination of the higher percentage of disability made

11-7  pursuant to NRS 616C.100 is appropriate and, if so, may order the

11-8  insurer to pay to the employee an amount equal to the maximum

11-9  allowable fee established by the Administrator pursuant to NRS

11-10  616C.260 for the type of service performed, or the usual fee of that

11-11  physician or chiropractor for such service, whichever is less.

11-12     5.  The hearing officer shall order an insurer, organization for

11-13  managed care or employer who provides accident benefits for

11-14  injured employees pursuant to NRS 616C.265 to pay the charges of

11-15  a provider of health care if the conditions of NRS 616C.138 are

11-16  satisfied.

11-17     6.  The hearing officer may allow or forbid the presence of a

11-18  court reporter and the use of a tape recorder in a hearing.

11-19     7.  The hearing officer shall render his decision within 15 days

11-20  after:

11-21     (a) The hearing; or

11-22     (b) He receives a copy of the report from the medical

11-23  examination he requested.

11-24     8.  The hearing officer shall render his decision in the most

11-25  efficient format developed by the Chief of the Hearings Division of

11-26  the Department of Administration.

11-27     9.  The hearing officer shall give notice of his decision to each

11-28  party by mail. He shall include with the notice of his decision the

11-29  necessary forms for appealing from the decision.

11-30     10.  Except as otherwise provided in NRS 616C.380, the

11-31  decision of the hearing officer is not stayed if an appeal from that

11-32  decision is taken unless an application for a stay is submitted by a

11-33  party. If such an application is submitted, the decision is

11-34  automatically stayed until a determination is made on the

11-35  application. A determination on the application must be made within

11-36  30 days after the filing of the application. If, after reviewing the

11-37  application, a stay is not granted by the hearing officer or an appeals

11-38  officer, the decision must be complied with within 10 days after the

11-39  refusal to grant a stay.

11-40     Sec. 23.  NRS 616C.345 is hereby amended to read as follows:

11-41     616C.345  1.  Any party aggrieved by a decision of the

11-42  hearing officer relating to a claim for compensation may appeal

11-43  from the decision by filing a notice of appeal with an appeals officer

11-44  within 30 days after the date of the decision.

11-45     2.  If a dispute is required to be submitted to a procedure for

11-46  resolving complaints pursuant to NRS 616C.305 and:


12-1      (a) A final determination was rendered pursuant to that

12-2  procedure; or

12-3      (b) The dispute was not resolved pursuant to that procedure

12-4  within 14 days after it was submitted,

12-5  any party to the dispute may file a notice of appeal within 70 days

12-6  after the date on which the final determination was mailed to the

12-7  employee, or his dependent, or the unanswered request for

12-8  resolution was submitted. Failure to render a written determination

12-9  within 30 days after receipt of such a request shall be deemed by the

12-10  appeals officer to be a denial of the request.

12-11     3.  Except as otherwise provided in NRS 616C.380, the filing of

12-12  a notice of appeal does not automatically stay the enforcement of the

12-13  decision of a hearing officer or a determination rendered pursuant to

12-14  NRS 616C.305. The appeals officer may order a stay, when

12-15  appropriate, upon the application of a party. If such an application is

12-16  submitted, the decision is automatically stayed until a determination

12-17  is made concerning the application. A determination on the

12-18  application must be made within 30 days after the filing of the

12-19  application. If a stay is not granted by the officer after reviewing

12-20  the application, the decision must be complied with within 10 days

12-21  after the date of the refusal to grant a stay.

12-22     4.  Except as otherwise provided in [this subsection,]

12-23  subsection 5, the appeals officer shall, within 10 days after

12-24  receiving a notice of appeal pursuant to this section or a contested

12-25  claim pursuant to subsection 5 of NRS 616C.315 [, schedule] :

12-26     (a) Schedule a hearing on the merits of the appeal or contested

12-27  claim for a date and time within 90 days after his receipt of the

12-28  notice at a place in Carson City, Nevada, or Las Vegas, Nevada, or

12-29  upon agreement of one or more of the parties to pay all additional

12-30  costs directly related to an alternative location, at any other place

12-31  of convenience to the parties, at the discretion of the appeals

12-32  officer; and [give]

12-33     (b) Give notice by mail or by personal service to all parties to

12-34  the matter and their attorneys or agents at least 30 days before the

12-35  date and time scheduled.

12-36     5.  A request to schedule the hearing for a date and time which

12-37  is:

12-38     (a) Within 60 days after the receipt of the notice of appeal or

12-39  contested claim; or

12-40     (b) More than 90 days after the receipt of the notice or

12-41  claim,

12-42  may be submitted to the appeals officer only if all parties to the

12-43  appeal or contested claim agree to the request.

12-44     [5.] 6. An appeal or contested claim may be continued upon

12-45  written stipulation of all parties, or upon good cause shown.


13-1      [6.] 7. Failure to file a notice of appeal within the period

13-2  specified in subsection 1 or 2 may be excused if the party aggrieved

13-3  shows by a preponderance of the evidence that he did not receive

13-4  the notice of the determination and the forms necessary to appeal the

13-5  determination. The claimant, employer or insurer shall notify the

13-6  hearing officer of a change of address.

13-7      Sec. 24.  1.  The Commissioner of Insurance shall conduct a

13-8  study to review whether the State of Nevada should enact, in the

13-9  interest of the public:

13-10     (a) The Defined Limits Version of the Investments of Insurers

13-11  Model Act adopted by the National Association of Insurance

13-12  Commissioners;

13-13     (b) The Defined Standards Version of the Investments of

13-14  Insurers Model Act adopted by the National Association of

13-15  Insurance Commissioners; or

13-16     (c) Other legislation regulating the investments of insurers.

13-17     2.  The Commissioner shall seek to obtain all relevant

13-18  information from public and private sources as part of this study.

13-19  Any such information obtained by the Commissioner may only be

13-20  used for the purposes of conducting this study.

13-21     3.  The Commissioner shall complete this study and submit a

13-22  copy of his findings and recommendations on or before January 1,

13-23  2005, to the Director of the Legislative Counsel Bureau for

13-24  distribution to the 73rd Session of the Nevada Legislature.

13-25     Sec. 25.  1.  On or before December 31, 2004, the

13-26  Commissioner of Insurance shall prepare a report and submit the

13-27  report to the Governor and the Legislature. The report must address:

13-28     (a) The operation of sections 2 to 15, inclusive, of this act;

13-29     (b) The efficacy, necessity and desirability of using credit

13-30  information in making decisions related to insurance;

13-31     (c) The impacts upon the residents of Nevada of the continued

13-32  use of credit information in making decisions related to insurance;

13-33  and

13-34     (d) Any additional consumer protections identified by the

13-35  Commissioner for the consideration of the Legislature.

13-36     2.  As used in this section, “credit information” has the meaning

13-37  ascribed to it in section 7 of this act.

13-38     Sec. 26.  1.  This section and sections 1 and 16 to 25,

13-39  inclusive, of this act become effective on October 1, 2003.

13-40     2.  Sections 1.5 to 15, inclusive, of this act become effective on

13-41  July 1, 2004.

 

13-42  20~~~~~03