SECOND REGULAR SESSION

SENATE COMMITTEE SUBSTITUTE FOR

HOUSE BILL NO. 1292

90TH GENERAL ASSEMBLY


Reported from the Committee on Insurance and Housing, April 20, 2000, with recommendation that the Senate Committee Substitute do pass.

TERRY L. SPIELER, Secretary.

3073S.09C


AN ACT

To repeal sections 375.017, 375.126, 375.1168, 375.1176, 375.1182 and 384.043, RSMo 1994, and sections 317.001, 375.1220, 376.1361 and 461.051, RSMo Supp. 1999, and to enact in lieu thereof thirteen new sections relating to insurance.


Be it enacted by the General Assembly of the State of Missouri, as follows:

Section A.  Sections 375.017, 375.126, 375.1168, 375.1176, 375.1182 and 384.043, RSMo 1994, and sections 317.001, 375.1220, 376.1361 and 461.051, RSMo Supp. 1999, are repealed and thirteen new sections enacted in lieu thereof, to be known as sections 317.001, 317.019, 335.018, 374.285, 375.017, 375.1168, 375.1176, 375.1182, 375.1220, 376.1361, 376.1450, 384.043 and 461.051, to read as follows:

317.001.  As used in sections 317.001 to 317.021, the following words and terms mean:

(1)  "Bout", one match involving either professional boxing, sparring, professional wrestling, professional kickboxing or professional full-contact karate;

(2)  "Combative fighting", also known as "toughman fighting", "toughwoman fighting", "badman fighting", "ultimate fighting", "U.F.C." and "extreme fighting", any boxing or wrestling match, contest or exhibition, between two or more contestants, with or without protective headgear, who use their hands, with or without gloves, or their feet, or both, and who compete for a financial prize or any item of pecuniary value, and which match, contest, tournament championship or exhibition is not recognized by and not sanctioned by any officially recognized state, regional or national boxing or athletic sanctioning authority, or any promoter duly licensed by the department of economic development;

(3)  "Contest", a bout or a group of bouts involving licensed contestants competing in professional boxing, sparring, professional wrestling, professional kickboxing or professional full-contact karate;

(4)  "Contestant", a person who competes in any activity covered by sections 317.001 to 317.021;

(5)  "Department", the department of economic development;

(6)  "Director", the director of the department of economic development;

(7)  "Fund", the athletic fund established pursuant to sections 317.001 to 317.021;

(8)  "Mandatory count of eight", a required count of eight that is given by a referee to a contestant who has been knocked down;

(9)  "Noncompetitive boxing", boxing or sparring where a decision is not rendered;

(10)  "Office", the department of economic development, division of professional registration, office of athletics;

(11)  "Professional boxing", the sport of attack and defense which uses the fist and where contestants compete for valuable consideration;

(12) "Professional boxing promoter", any person, association, partnership, corporation or organization that holds a license or permit to organize, promote and produce professional boxing contests;

(13)  "Professional full-contact karate", any form of full-contact martial arts including but not limited to full-contact kungfu, full-contact taw kwon-do, or any form of martial arts or self-defense conducted on a full-contact basis in a bout or contest where weapons are not used and where contestants compete for valuable consideration.  Such contests take place in a rope-enclosed ring and are fought in timed rounds;

[(13)]  (14)  "Professional kickboxing", any form of boxing in which blows are delivered with any part of the arm below the shoulder, including the hand, and any part of the leg below the hip, including the foot, and where contestants compete for valuable consideration.  Such contests take place in a rope-enclosed ring and are fought in timed rounds;

[(14)]  (15)  "Professional wrestling", any performance of wrestling skills and techniques by two or more professional wrestlers, to which any admission is charged.  Participating wrestlers may not be required to use their best efforts in order to win, the winner may have been selected before the performance commences and contestants compete for valuable consideration.  Such contests take place in a rope-enclosed ring and are fought in timed rounds;

[(15)]  (16)  "Sparring", boxing for practice or as an exhibition;

[(16)]  (17)  "Standing mandatory eight count", the count of eight that is given at the discretion of a referee to a contestant who has been dazed by a blow and is unable to defend himself or herself.  The standing mandatory eight count may be waived in a bout only with special permission of the office.

317.019.  1.  The division of professional registration shall not issue any license or permit to a professional boxing promoter unless the promoter files proof of insurance not less than one hundred thousand dollars for each contestant participating in a professional boxing contest.  This insurance shall cover:

(1)  Hospital, medication, physician and other such expenses as would accrue in the treatment of an injury as a result of the boxing contest; and

(2)  Payment to the estate of the contestant in the event of his or her death as a result of his or her participation in the boxing contest.

2.  The insurance required pursuant to this section shall not apply to not for profit organizations sponsoring boxing contests.

335.018.  1.  As used in section 376.1190, RSMo, "registered nurse first assistant" means any person practicing in this state as a registered nurse who is licensed pursuant to this chapter and who:

(1)  Is certified by a nationally recognized professional organization for registered nurse first assistants; or

(2)  Meets the criteria for registered nurse first assistants established by the Missouri state board of nursing.

2.  The Missouri state board of nursing shall promulgate rules pursuant to chapter 536, RSMo, specifying which professional nursing organization certifications will be recognized for registered nurse first assistants and establishing the criteria a registered nurse must satisfy to use the title of registered nurse first assistant if the nurse is not certified by a nationally recognized professional nursing organization as a registered nurse first assistant.

3.  All insurance companies shall refer to this section for the definition of a registered nurse first assistant in order to determine whether such services provided qualify for reimbursement.  This section shall not be construed to mandate coverage for services provided by a registered nurse first assistant, however reimbursement for services provided by a registered nurse first assistant shall not be denied based on lack of statutory recognition.

374.285.  1.  All records of disciplinary actions against an insurance agent, broker, agency or producer which resulted in a voluntary forfeiture of two hundred dollars or less shall be expunged after a period of five years from the date of the execution of the voluntary forfeiture by the director of the department of insurance.

2.  After a period of five years from the date of the final order of discipline, any insurance agent, broker, agency or producer may apply to the director for the expungement of any record of disciplinary action taken by the director.  Disciplinary actions shall include, but not be limited to, reprimand, voluntary forfeiture, suspension or revocation.

3.  In considering any application for expungement, the director shall consider the length of time that has passed since the record was made public, the licensee's correction of any problem or offense which may have led to the creation of the record, the severity of the problem or offense, or other factors that the director deems appropriate.  The director may expunge any record for good cause shown.

4.  The director shall make a written decision on such petition no later than thirty days after the application.  The decision shall state whether the record will be expunged.  If the decision is that the record will not be expunged, each reason for the decision shall be stated in separate, enumerated paragraphs.  Any record that the director deems appropriate for expungement shall be expunged within thirty days of the date of the decision.

5.  If the director determines that any record shall not be expunged, the administrative remedies are deemed exhausted.  The applicant for expungement may then file an action for expungement of the record in either the circuit court of Cole County or the circuit court of the county where the applicant resides.

6.  Expunged records are not open to public inspection and shall be destroyed.

[375.017.  1.  A person not a legal resident of this state may be licensed to act in this state as an agent upon compliance with the provisions of this chapter provided that the state in which the person resides will accord the same privilege to a resident of this state.  The director is authorized to enter into reciprocal agreements with the appropriate official of any other state waiving the written examination of any applicant residing in the other state; provided, the director deems the applicant fully qualified and competent; and

(1)  That a written examination is required of applicants for similar licenses in the other state; and

(2)  That the appropriate official in that state certifies that the applicant holds a currently valid license as broker or agent in that state and either passed a written examination or was the holder of a license prior to the time a written examination was required.

2.  In the event that the applicant is a resident of a state which does not require a written examination, then the director shall subject him to a written examination under terms and conditions to be prescribed by the director of insurance.

3.  In the event that the applicant is a resident of another state in which the appropriate insurance official, as a general policy, has refused to permit legal residents of Missouri to become licensed as agents and to transact the business of insurance in such state, then the director shall not license any applicant from that state.] 375.017.  1.  (1)  The director shall not assess a greater fee for an insurance license or related service to a person not residing in this state based solely on the fact that the person does not reside in this state.

(2)  The director shall waive any license application requirements for a nonresident license applicant with a valid license from his or her home state, except the requirements imposed by subsection 2 of this section, if the applicant's home state awards nonresident licenses to residents of this state on the same basis.

(3)  A nonresident licensee's satisfaction of his or her home state's continuing education requirements for licensees shall constitute satisfaction of this state's continuing education requirements if the nonresident licensee's home state recognizes the satisfaction of its continuing education requirement imposed upon licensees from this state on the same basis.  This section shall also apply to surplus line licensees licensed pursuant to chapter 384, RSMo.

2.  (1)  Unless denied pursuant to section 375.141, a nonresident person shall receive a nonresident agent or broker's license if:

(a)  The person is currently licensed for the same line of authority as a resident and in good standing in his or her home state;

(b)  The person has submitted the proper request for licensure and has paid the fees required by law;

(c)  The person has submitted or transmitted to the director the application for licensure that the person submitted to his or her home state, or in lieu of the same, a completed uniform application; and

(d)  The person's home state awards nonresident licenses to residents of this state on the same basis.

(2)  Notwithstanding any other provision of sections 375.012 to 375.146, a person licensed as a surplus licensee in his or her home state shall receive a nonresident surplus lines license pursuant to subdivision (1) of this subsection.  Except as provided in subdivision (1) of this subsection, nothing in this subsection otherwise amends or supercedes any provision of chapter 384, RSMo.

(3)  Notwithstanding any other provision of sections 375.012 to 375.146, a person licensed as a limited line credit insurance or other type of limited lines licensee in his or her home state shall receive a nonresident limited lines license, pursuant to subdivision (1) of this subsection, granting the same scope of authority as granted under the license issued by the licensee's home state.

3.  An individual who applies for an agent or broker's license in this state who was previously licensed for the same lines of authority in another state shall not be required to complete any prelicensing education or examination.  This exemption is only available if the person is currently licensed in that state or if the application is received within ninety days of the cancellation of the applicant's previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in the state or the state's licensee database records, maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries, indicate that the licensee was licensed in good standing for the line of authority requested.

4.  Subsections 1 to 3 of this section do not apply to excess and surplus licensees licensed pursuant to chapter 384, RSMo, except as provided in subdivision (3) of subsections 1 and 2 of this section.

[375.126.  A person not a legal resident of this state may be licensed to act in this state as a broker upon compliance with the provisions of this chapter; provided that the state in which the person resides will accord the same privilege to a resident of this state; provided that a written examination is required of applicants for similar licenses in the other state and that the appropriate official in that state certifies that the applicant holds a currently valid license as broker or agent in that state and either passed a written examination or was the holder of a license prior to the time a written examination was required.] 375.1168.  1.  The director as rehabilitator may appoint one or more special deputies, who shall have all the powers and responsibilities of the rehabilitator granted under this section, and the director may employ such counsel, clerks and assistants as deemed necessary, except that no person shall be employed by the rehabilitator who is related within the second degree by blood or by marriage to the rehabilitator, special deputy rehabilitator, or to any member or employee of a law firm, consultant or other person receiving fees or other income from the insurer's assets.  An attorney who serves as a special deputy rehabilitator may not also serve as counsel to the rehabilitator or to the company in rehabilitation.  This restriction shall also apply to any law firm with which the special deputy rehabilitator is affiliated.  The compensation of the special deputy, counsel, clerks and assistants and all expenses of taking possession of the insurer and of conducting the proceedings shall be fixed by the director with the approval of the court and shall be paid out of the funds or assets of the insurer.  The persons appointed under this section shall serve at the pleasure of the director.  In the event that the property of the insurer does not contain sufficient cash or liquid assets to defray the costs incurred, the director may advance the costs so incurred out of any appropriation to the department for such purpose.  Any amounts so advanced for expenses or administration shall be repaid to the director out of the first available money of the insurer, and shall be paid by the director to the state treasurer for deposit to the general revenue fund.

2.  The rehabilitator may take such action as he deems necessary or appropriate to reform and revitalize the insurer.  He shall have all the powers of the directors, officers, and managers, whose authority shall be suspended, except as they are redelegated by the rehabilitator.  He shall have full power to direct and manage, to hire and discharge employees subject to any contract rights they may have, and to deal with property and business of the insurer.

3.  If it appears to the rehabilitator that there has been criminal or tortious conduct, or breach of any contractual or fiduciary obligation detrimental to the insurer by any officer, manager, agency, employee or other person, the rehabilitator may pursue all appropriate legal remedies on behalf of the insurer, subject to prior court approval.  Upon application of the rehabilitator for authority to pursue legal remedies on behalf of the insurer, and after such notice and hearing as the court may prescribe, the court shall consider the anticipated costs and benefits and shall not approve the pursuit of legal remedies unless the court finds there is a reasonable likelihood that the economic benefits will exceed the costs.  The court may impose such conditions on the rehabilitator's pursuit of legal remedies as may contribute to the conservation of the insurer's assets, which conditions may be imposed either at the time approval is given for pursuit of legal remedies or at any later time.

4.  If the rehabilitator determines that reorganization, consolidation, conversion, reinsurance, merger or other transformation of the insurer is appropriate, he shall prepare a plan to effect such changes and file the plan with the court within ninety days of the order of rehabilitation.  Upon application of the rehabilitator for approval of the plan, and after such notice and hearings as the court may prescribe, the court may either approve or disapprove the plan proposed, or may modify it and approve it as modified.  Any plan approved under this section shall be, in the judgment of the court, fair and equitable to all parties concerned.  If the plan is approved, the rehabilitator shall carry out the plan.  In the case of a life insurer, the plan proposed may include the imposition of liens upon the policies of the company, if all rights of shareholders are first relinquished.  A plan for a life insurer may also propose imposition of a moratorium upon loan and cash surrender rights under policies, for such period and to such an extent as may be necessary.

5.  The rehabilitator shall have all powers provided by law to avoid fraudulent transfers.

6.  The rehabilitator, with the approval of the court, may appoint an advisory committee of policyholders, claimants, or other creditors should such a committee be deemed necessary.  Such committee shall serve at the pleasure of the rehabilitator and shall serve without compensation other than reimbursement for reasonable travel and other expenses.  No other committee of any nature shall be appointed by the rehabilitator or the court in rehabilitation proceedings conducted under this section.

7.  No attorney other than the attorney general may appear on behalf of the rehabilitator in the court of appeals or in the supreme court when the question before the court involves a lower court opinion or order releasing the company in rehabilitation from that rehabilitation.

375.1176.  1.  An order to liquidate the business of a domestic insurer shall appoint the director and his successors as liquidator and shall direct the liquidator forthwith to take immediate possession of the assets of the insurer and to administer them subject to the supervision of the court until the liquidator is discharged by the court.  The liquidation of any insurer shall be considered to be the business of insurance for purposes of application of any law of this state.  The liquidator shall be vested by operation of law with the title to all of the property, contracts and rights of action, and all of the books and records of the insurer ordered liquidated, wherever located, as of the entry of the order of liquidation.  The order shall require the liquidator to take immediate possession of and to secure all of the records and property of the insurer wherever it is located, and to take all measures necessary to preserve the integrity of the insurer's records.  The filing or recording of the order with the clerk of the court and the recorder of deeds of the county in which its principal office or place of business is located or, in the case of real estate, with the recorder of deeds of the county where the property is located, shall impart the same notice as a deed, bill of sale or other evidence of title duly filed or recorded with that recorder of deeds would have imparted.

2.  With the approval of the court, the director as liquidator may appoint a special deputy or deputies to act for him under sections 375.1175 to 375.1230.  The special deputy shall not be an employee of the department of insurance and shall not be anyone who served as a special deputy rehabilitator for the same insurer.  The special deputy shall have all powers of the liquidator granted by sections 375.1175 to 375.1230.  The special deputy shall administer and liquidate the insolvent insurer subject to the general supervision of the director and the specific supervision of the court as provided in sections 375.1175 to 375.1230.

3.  Upon issuance of the order of liquidation, the rights and liabilities of any such insurer and of its creditors, policyholders, shareholders, members and any other persons interested in its estate shall become fixed and the termination of any period fixed by any statute of limitations provided by law shall be suspended as of the date of entry of the order of liquidation, except as provided in sections 375.1178, 375.1206 and 375.1210.  Rights of shareholders provided by any law other than as provided by sections 375.1150 to 375.1246 shall be suspended upon issuance of the order of liquidation.

4.  An order to liquidate the business of an alien insurer domiciled in this state shall be in the same terms and have the same legal effect as an order to liquidate a domestic insurer, except that the assets and the business in the United States shall be the only assets and business included therein.

5.  At the time of petitioning for an order of liquidation, or at any time thereafter, the director, after making determination of an insurer's insolvency, may petition the court for a judicial declaration of such insolvency.  After providing such notice and hearing as it deems proper, the court may make the declaration.

6.  (1)  Any order issued under this section shall require periodic financial reports to the court by the liquidator.  Financial reports shall include, at a minimum, the assets and liabilities of the insurer and all funds received or disbursed by the liquidator during the current period.  Financial reports shall be filed within one year of the liquidation order and at least annually thereafter.

(2)  After an order of liquidation has been entered, the liquidator of such insurer shall file with the director a statement which shall reflect the claims reserves, including losses incurred but not reported, and unearned premium reserves which have been established by the liquidator and which shall also set forth the amounts of such reserves that are allocable to particular reinsurers of the insolvent company.  A similar statement shall be filed by each liquidator not less frequently than annually and shall be considered for all intents and purposes as the annual statement which was required to be filed by the insurer with the director prior to the liquidation proceedings.  To the extent that any reinsurer of an insurer in liquidation would have been required under any agreement pertaining to reinsurance to post letters of credit or other security prior to an order of liquidation to cover such reserves reflected upon a statement filed with a regulatory authority, such reinsurer shall be required to post letters of credit or other security to cover such reserves after an insurer has been placed in liquidation.  If a reinsurer shall fail to post letters of credit or other security required by a reinsurance agreement or the provisions of this section, the director may issue an order barring such reinsurer from thereafter reinsuring any insurer which is incorporated under the laws of the state of Missouri.

7.  (1)  Within five days after the initiation of an appeal of an order of liquidation, the liquidator shall present for the court's approval a plan for the continued performance of the defendant company's policy claims obligations, including the duty to defend insureds under liability insurance policies, during the pendency of an appeal.  Such plan shall provide for the continued performance and payment of policy claims obligations in the normal course of events, notwithstanding the grounds alleged in support of the order of liquidation including the ground of insolvency.  In the event the defendant company's financial condition, in the judgment of the liquidator, will not support the full performance of all policy claims obligations during the appeal pendency period, the plan may prefer the claims of certain policyholders and claimants over creditors and interested parties as well as other policyholders and claimants, as the liquidator finds to be fair and equitable considering the relative circumstances of such policyholders and claimants.  The court shall examine the plan submitted by the liquidator and if it finds the plan to be in the best interests of the parties, the court shall approve the plan.  No action shall lie against the liquidator or any of his deputies, agents, clerks, assistants or attorneys by any party based on preference in an appeal pendency plan approved by the court.

(2)  The appeal pendency plan shall not supersede or affect the obligations of any insurance guaranty association.

(3)  Any such plans shall provide for equitable adjustments to be made by the liquidator to any distributions of assets to guaranty associations, in the event that the liquidator pays claims from assets of the estate, which would otherwise be the obligations of any particular guaranty association but for the appeal of the order of liquidation, such that all guaranty associations equally benefit on a pro rata basis from the assets of the estate.  Further, in the event an order of liquidation is set aside upon any appeal, the company shall not be released from delinquency proceedings unless and until all funds advanced by any guaranty association, including reasonable allocated loss adjustment expenses in connection therewith relating to obligations of the company, shall be repaid in full, together with interest at the judgment rate of interest or unless an arrangement for repayment thereof has been made with the consent of all applicable guaranty associations.

8.  Any person who shall knowingly destroy, conceal, convert or alter any records or property of an insurer after entry of an order of liquidation, without having received prior written permission of the liquidator or of the court, or who shall knowingly neglect or refuse, upon the order or demand of the liquidator, to deliver to the liquidator any records or property of an insurer in his possession or control, shall be guilty of a class C felony.

375.1182.  1.  The liquidator shall have the power:

(1)  To employ employees and agents, legal counsel, actuaries, accountants, appraisers, consultants and such other personnel as he may deem necessary to assist in the liquidation, except that no person shall be employed by the liquidator who is related within the second degree by blood or by marriage to the liquidator, special deputy liquidator, or to any employee of a law firm, consultant or other person receiving fees or other income from the insurer's assets;

(2)  To fix the reasonable compensation of employees and agents, legal counsel, actuaries, accountants, appraisers and consultants with the approval of the court;

(3)  To pay reasonable compensation to persons appointed and to defray from the funds or assets of the insurer all expenses of taking possession of, conserving, conducting, liquidating, disposing of, or otherwise dealing with the business and property of the insurer.  In the event that the property of the insurer does not contain sufficient cash or liquid assets to defray the costs incurred, the director may advance the costs so incurred out of funds appropriated for that purpose.  Any amounts so advanced for expenses of administration shall be repaid to the director out of the first available moneys of the insurer and such funds repaid shall be transferred by the director to the state treasurer for deposit to the general revenue fund;

(4)  To hold hearings, to subpoena witnesses to compel their attendance, to administer oaths, to examine any persons under oath, and to compel any person to subscribe to his testimony after it has been correctly reduced to writing; and in connection therewith to require the production of any books, papers, records or other documents which he deems relevant to the inquiry;

(5)  To audit the books and records of all agents of the insurer insofar as those records relate to the business activities of the insurer;

(6)  To collect all debts and moneys due and claims belonging to the insurer, wherever located, and for this purpose:

(a)  To institute timely action in other jurisdictions, in order to forestall garnishment and attachment proceedings against such debts;

(b)  To do such other acts as are necessary or expedient to collect, conserve or protect its assets or property, including the power to sell, compound, compromise or assign debts for purposes of collection upon such terms and conditions as he deems best; and

(c)  To pursue any creditor's remedies available to enforce his claims;

(7)  To conduct public and private sales of the property of the insurer;

(8)  To use assets of the estate of an insurer under a liquidation order to transfer policy obligations to a solvent assuming insurer, if the transfer can be arranged without prejudice to applicable priorities under section 375.1218;

(9)  To acquire, hypothecate, encumber, lease, improve, sell, transfer, abandon or otherwise dispose of or deal with, any property of the insurer at its market value or upon such terms and conditions as are fair and reasonable.  He shall also have power to execute, acknowledge and deliver any and all deeds;

(10)  To borrow money on the security of the insurer's assets or without security and to execute and deliver all documents necessary to that transaction for the purpose of facilitating the liquidation.  Any such funds borrowed may be repaid as an administrative expense and have priority over any other claims in class 1 under the priority of distribution;

(11)  To enter into such contracts as are necessary to carry out the order to liquidate, and to affirm or disavow any contracts to which the insurer is a party;

(12)  To continue to prosecute and to institute in the name of the insurer or in his own name any and all suits and other legal proceedings, in this state or elsewhere, and, with the approval of the supervising court, to abandon the prosecution of claims he deems unprofitable to pursue further.  If the insurer is dissolved under section 375.1180, he shall have the power to apply to any court in this state or elsewhere for leave to substitute himself for the insurer as plaintiff;

(13)  To prosecute any action which may exist on behalf of the creditors, members, policyholders or shareholders of the insurer against any officer of the insurer, or any other person;

(14)  To institute proceedings in the same case for receivership for any organization or corporation having the exclusive or dominant right to manage or control the insurer which is the subject of the main case, when it appears that a receiver is necessary for the preservation of the assets of the insurer or that a receiver is necessary to determine the assets of the insurer held by the organization or corporation.  The duration of the receivership and the duties of the receiver shall be in the discretion of the court;

(15)  To remove any or all records and property of the insurer to the offices of the director or to such other place as may be convenient for the purposes of efficient and orderly execution of the liquidation.  Guaranty associations and foreign guaranty associations shall have such reasonable access to the records of the insurer as is necessary for them to carry out their legal obligations;

(16)  To deposit in one or more banks in this state such sums as are required for meeting current administration expenses and dividend distributions and to invest all sums not currently needed, unless the court orders otherwise; provided that, at the election of the supervising court, funds held by the liquidator of the insurer's estate shall be deposited and invested by the liquidator pursuant to either of the following standards as the court shall order:

(a)  The standards specified by law for the deposit and investment of state funds by the state treasurer, as such standards are determined to be applicable by the court;

(b)  The standards specified by law for the investment of money and property of the Missouri state employees' retirement system, as such standards are determined to be applicable by the court;

(17)  To file any necessary documents for record in the office of any recorder of deeds or other office in this state or elsewhere where property of the insurer is located;

(18)  To assert all defenses available to the insurer as against third persons, including statutes of limitation, statutes of frauds, and the defense of usury.  A waiver of any defense by the insurer after a petition in liquidation has been filed shall not bind the liquidator.  Whenever a guaranty association or foreign guaranty association has an obligation to defend any suit, the liquidator shall give precedence to such obligation and may defend only in the absence of a defense by such guaranty associations;

(19)  To exercise and enforce all the rights, remedies, and powers of any creditor, shareholder, policyholder or member, including any power to avoid any transfer or lien that may be given by the general law and that is not included [with] within sections 375.1192 to 375.1195, except for any right of distribution pursuant to section 375.1218;

(20)  To intervene in any proceeding wherever instituted that might lead to the appointment of a receiver or trustee, and to act as the receiver or trustee whenever the appointment is offered;

(21)  To enter into agreements with any receiver or director of any other state relating to the rehabilitation, liquidation, conservation or dissolution of an insurer doing business in both states; and

(22)  To exercise all powers now held or hereafter conferred upon receivers by the laws of this state not inconsistent with the provisions of sections 375.1150 to 375.1246.

2.  (1)  If an insurer being liquidated issued liability policies on a claims-made basis, which provided an option to purchase an extended period to report claims, then the liquidator may make available to holders of such policies, for a charge, an extended period to report claims as stated herein.  The extended reporting period shall be made available only to those insureds who have not secured substitute coverage.  The extended period made available by the liquidator shall begin upon termination of any extended period to report claims in the basic policy and shall end at the earlier of the final date for filing of claims in the liquidation proceeding or eighteen months from the entry of the order of liquidation.

(2)  The extended period to report claims made available by the liquidator shall be subject to the terms of the policy to which it relates.  The liquidator shall make available such extended period within sixty days after the order of liquidation at a charge to be determined by the liquidator subject to approval of the court.  Such offer shall be deemed rejected unless the offer is accepted in writing and the charge is paid within ninety days after the order of liquidation.  No commissions, premium taxes, assessments or other fees shall be due on the charges paid by policyholders pertaining to the extended period to report claims.

3.  The enumeration in this section of the powers and authority of the liquidator shall not be construed as a limitation upon him, nor shall it exclude in any manner his right to do such other acts not herein specifically enumerated, or otherwise provided for, as may be necessary or appropriate for the accomplishment of or in aid of the purpose of liquidation.

4.  Notwithstanding the powers of the liquidator as stated in this section, the liquidator shall have no obligation to defend claims or to continue to defend claims subsequent to the discharge of the liquidator.

5.  The director as liquidator, any special deputy, all employees, agents and attorneys of the liquidator and the special deputy, and all employees of the state of Missouri when acting with respect to the liquidation shall be considered to be officers of the court when acting in such capacities and as such shall be subject to the orders and directions of the court with respect to their actions or omissions in connection with the liquidation.  The liquidator, special deputy, commissioners and referees appointed by the court, the agents, attorneys and employees of the liquidator and employees of the state of Missouri when acting with respect to the liquidation shall enjoy absolute judicial immunity and be immune from any claim against them personally for any act or omission committed in the performance of their functions and duties in connection with the liquidation.

6.  Notwithstanding the provisions of section 375.1158, subdivision (16) of subsection 1 of this section shall apply to and govern delinquency proceedings commenced before and after August 28, 1991.

7.  No attorney other than the attorney general may appear on behalf of the liquidator in the court of appeals or in the supreme court when the question before the court involves a lower court opinion or order involving the liquidation of a company.

375.1220.  1.  The liquidator shall review all claims duly filed in the liquidation and shall make such further investigation as the liquidator shall deem necessary.  The liquidator may compound, compromise or in any other manner negotiate the amount for which claims will be allowed, under the supervision of the court, except where the liquidator is required by law to accept claims as settled by any person or organization.  Unresolved disputes shall be determined pursuant to section 375.1214.  No claim under a policy of insurance shall be allowed for any amount in excess of the applicable policy limits or without regard to policy deductibles.

2.  If the fixing or liquidation of any claim or claims would unduly delay the administration of the liquidation or if the administrative expense of processing and adjudication of a claim or group of claims of a similar type would be unduly excessive when compared with the moneys which are estimated to be available for distribution with respect to such claim or group of claims, the determination and allowance of such claim or claims may be made by an estimate.  Any such estimate shall be based upon an actuarial evaluation made with reasonable actuarial certainty or upon another accepted method of valuing claims with reasonable certainty.

3.  The estimation of contingent liabilities permitted by subsection 2 of this section or any other section of this chapter may be used for the purpose of fixing a creditor's claim in the estate, and for determining the percentage of partial or final [divided] dividend payments to be paid to creditors with reported allowed claims.  However, nothing in subsection 2 of this section or any other section in this chapter shall be construed as authorizing the receiver, or any other entity, to compel payment from a reinsurer on the basis of estimated incurred but not reported losses and, except with respect to claims made pursuant to section 375.1212, outstanding reserves.  Nothing in this subsection shall be construed to impair any obligation arising pursuant to any insurance agreement.

4.  Notwithstanding the provisions of this section or any other section of this chapter to the contrary, the liquidator may negotiate a voluntary commutation and release of all obligations arising from reinsurance contracts or other agreements.

5.  The provisions of subsection 3 of this section shall not apply to and have no force and effect regarding any formal delinquency proceeding in which, prior to [the effective date of this act] August 28, 1999, the court in which such proceeding was or is pending issued any order or decree construing or applying the provisions of this section.

6.  Subsections 3[, 4] and 5 of this section shall terminate on December 31, [2000] 2004.

376.1361.  1.  A utilization review program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing efficacy.  A health carrier may develop its own clinical review criteria, or it may purchase or license clinical review criteria from qualified vendors.  A health carrier shall make available its clinical review criteria upon request by either the director of the department of health or the director of the department of insurance.

2.  Any medical director who administers the utilization review program or oversees the review decisions shall be a qualified health care professional licensed in the state of Missouri.  A licensed clinical peer shall evaluate the clinical appropriateness of adverse determinations.

3.  A health carrier shall issue utilization review decisions in a timely manner pursuant to the requirements of sections 376.1363, 376.1365 and 376.1367.  A health carrier shall obtain all information required to make a utilization review decision, including pertinent clinical information.  A health carrier shall have a process to ensure that utilization reviewers apply clinical review criteria consistently.

4.  A health carrier's data systems shall be sufficient to support utilization review program activities and to generate management reports to enable the health carrier to monitor and manage health care services effectively.

5.  If a health carrier delegates any utilization review activities to a utilization review organization, the health carrier shall maintain adequate oversight, which shall include:

(1)  A written description of the utilization review organization's activities and responsibilities, including reporting requirements;

(2)  Evidence of formal approval of the utilization review organization program by the health carrier; and

(3)  A process by which the health carrier evaluates the performance of the utilization review organization.

6.  The health carrier shall coordinate the utilization review program with other medical management activities conducted by the carrier, such as quality assurance, credentialing, provider contracting, data reporting, grievance procedures, processes for accessing member satisfaction and risk management.

7.  A health carrier shall provide enrollees and participating providers with timely access to its review staff by a toll-free number.

8.  When conducting utilization review, the health carrier shall collect only the information necessary to certify the admission, procedure or treatment, length of stay, frequency and duration of services.

9.  Compensation to persons providing utilization review services for a health carrier shall not contain direct or indirect incentives for such persons to make medically inappropriate review decisions.  Compensation to any such persons may not be directly or indirectly based on the quantity or type of adverse determinations rendered.

10.  A health carrier shall permit enrollees or a provider on behalf of an enrollee to appeal for the coverage of medically necessary pharmaceutical prescriptions and durable medical equipment as part of the health carriers' utilization review process.

11.  (1)  This subsection shall apply to:

(a)  Any health benefit plan that is issued, amended, delivered or renewed on or after January 1, 1998, and provides coverage for drugs; or

(b)  Any person making a determination regarding payment or reimbursement for a prescription drug pursuant to such plan.

(2)  A health benefit plan that provides coverage for drugs shall provide coverage for any drug prescribed to treat an indication so long as the drug has been approved by the FDA for at least one indication, if the drug is recognized for treatment of the covered indication in one of the standard reference compendia or in substantially accepted peer-reviewed medical literature and deemed medically appropriate.

(3)  This section shall not be construed to require coverage for a drug when the FDA has determined its use to be contraindicated for treatment of the current indication.

(4)  A drug use that is covered pursuant to subsection 1 of this section shall not be denied coverage based on a "medical necessity" requirement except for a reason that is unrelated to the legal status of the drug use.

(5)  Any drug or service furnished in a research trial, if the sponsor of the research trial furnishes such drug or service without charge to any participant in the research trial, shall not be subject to coverage pursuant to subsection 1 of this section.

(6)  Nothing in this section shall require payment for nonformulary drugs, except that the state may exclude or otherwise restrict coverage of a covered outpatient drug from Medicaid programs as specified in the Social Security Act, Section 1927(d)(1)(B).

12.  A carrier shall issue a confirmation number to an enrollee when the health carrier, acting through a participating provider or other authorized representative, authorizes the provision of health care services.

13.  If an authorized representative of a health carrier authorizes the provision of health care services, the health carrier shall not subsequently retract its authorization after the health care services have been provided, or reduce payment for an item or service furnished in reliance on approval, unless

(1)  Such authorization is based on a material misrepresentation or omission about the treated person's health condition or the cause of the health condition; or

(2)  The health benefit plan terminates before the health care services are provided; or

(3)  The covered person's coverage under the health benefit plan terminates before the health care services are provided; or

(4)  The health carrier's coverage is secondary to other valid insurance coverage applicable to the health care services pursuant to a coordination of benefits provision in the health benefit plan; or

(5)  The covered person's coverage under the health benefit plan has exceeded such person's annual or lifetime benefits limit; or

(6)  The provisions of this subsection shall not apply to accident only, specified disease, hospital indemnity, Medicare supplement, long term care, disability income, or other limited benefit health insurance policies.

376.1450.  An enrollee, as defined in section 376.1350, may waive his or her right to receive documents and materials from a managed care entity in printed form so long as such documents and materials are readily accessible electronically through the entity's Internet site.  An enrollee may revoke such waiver at any time by notifying the managed care entity by phone or in writing.  Any enrollee who does not execute such a waiver and prospective enrollees shall have documents and materials from the managed care entity provided in printed form.  For purposes of this section, "managed care entity" includes, but is not limited to, a health maintenance organization, preferred provider organization, point of service organization and any other managed health care delivery entity of any type or description.

384.043.  1.  No agent or broker licensed by the state shall procure any contract of surplus lines insurance with any nonadmitted insurer, unless he possesses a current surplus lines insurance license issued by the director.

2.  The director shall issue a surplus lines license to any qualified resident holder of a current property and casualty broker's license but only when the broker has:

(1)  Remitted the one hundred dollar initial fee to the director;

(2)  Submitted a completed license application on a form supplied by the director;

(3)  Passed a qualifying examination approved by the director, except that all holders of a license prior to July 1, 1987, shall be deemed to have passed such an examination; and

(4)  Filed with the director, and maintains during the term of the license, in force and unimpaired, a bond in favor of this state in the penal sum of [ten] one hundred thousand dollars or in a sum equal to the broker's tax liability for the previous tax year, whichever is smaller, aggregate liability, with corporate sureties approved by the director.  The bond shall be conditioned that the surplus lines licensee will conduct business in accordance with the provisions of sections 384.011 to 384.071 and will promptly remit the taxes as provided by law.  No bond shall be terminated unless at least thirty days' prior written notice is given to the licensee and director.  If the director determines that a surplus lines licensee of a reciprocal sister state is competent and trustworthy, then he may, in his discretion, issue a nonresident surplus lines agent's license.  A nonresident licensee shall be limited in his authority to servicing of business negotiated elsewhere and filing any appropriate taxes.  A nonresident licensee shall not solicit business.

3.  Each surplus lines license shall be renewed annually on the anniversary date of issuance and continue in effect until refused, revoked or suspended by the director in accordance with section 384.065; except that if the annual renewal fee for the license is not paid on or before the anniversary date the license terminates.  The annual renewal fee is fifty dollars.

461.051.  1.  For all beneficiary designations made on or after August 28, 1989, if, after an owner makes such a beneficiary designation, the owner's marriage is dissolved or annulled, any provision of the beneficiary designation in favor of the owner's former spouse or a relative of the owner's former spouse is revoked on the date the marriage is dissolved or annulled, whether or not the beneficiary designation refers to marital status.  The beneficiary designation shall be given effect as if the former spouse or relative of the former spouse had disclaimed the revoked provision.

2.  Subsection 1 of this section does not apply to a provision of a beneficiary designation that has been made irrevocable, or revocable only with the spouse's consent, or that is made after the marriage was dissolved, or that expressly states that marriage dissolution shall not affect the designation of a spouse or relative of a spouse as beneficiary.

3.  Any provision of a beneficiary designation revoked solely by this section is revived by the owner's remarriage to the former spouse or by a nullification of the marriage dissolution or annulment.

4.  In this section, "a relative of the owner's former spouse" means an individual who is related to the owner's former spouse by blood, adoption or affinity and who, after the divorce or annulment, is not related to the owner by blood, adoption or affinity.