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Oklahoma Compliance Overview
- 1. Oklahoma Compliance Overview 2/19/202112:16:17 PM Contributory/Comparative Negligence Contributory • Not applicable Not applicable Comparative • Modified Comparative Fault (51% bar) 23 O.S. §13 Comparative Negligence 23 O.S. §14 Damages Diminished in Proportion to Contributory Negligence Minimum Limits Minimal Limits (000) (Person/Accident/PD) • 25/50/25 47 O.S. §7-103 Definitions Medical Payments Required - No • Optional; can include hospital, surgical, chiropractor and dental expenses • Must include funeral expenses, unless policy specifically excludes coverage See policy Okla. Admin. Code sect. 365:15-1-16 Standard Policy Provision -- Medical Payments Primacy • No provision No provision UM/UIM UM/UIM Separate Coverage No. UM/UIM Coverage Required (G) Mandatory; insured may reject in writing. 36 O.S. §3636 Uninsured Motorist Coverage UM/UIM Minimum Limits (H) FR=25/50. FR=25/50. 36 O.S. §3636 Uninsured Motorist Coverage 47 O.S. §7-103 Definitions Stacking Permitted This information applies to both single and multiple policies. Stacking is permitted in Oklahoma when insured has paid separate premiums, but Class II insureds 36 O.S. §3636 Uninsured Motorist Coverage Spears v. Glens Falls Ins. Co., 114 P.3d 448
- 2. cannot stack coveragesand single policy stacking can be prohibited by clear policy language. (B) Stacking not permitted within one policy. Policies shall not be subject to stacking or aggregation of limits unless expressly provided for by an insurance carrier. Where the uninsured/underinsured motorist (UM/UIM) coverage form conforms with this section, the policy is renewed annually with the insureds being provided coverage summaries at each renewal, a single premium is charged for multiple vehicles having UM/UIM coverage, and policy language provides that liability for UM/UIM coverage is limited to the maximum amount payable for all damages regardless of the number of vehicles insured, an insurance company need not provide the insureds with pre-policy notice that stacking of UM/UIM coverage is prohibited. Insureds may stack their underinsured motorist (UM) coverage for the additional vehicles under a policy if they have paid separate UM premiums for each vehicle, or if they have separate policies and pay UM premiums for each policy. In Oklahoma, the number of uninsured motorist coverages on which an insured is entitled to rely is determined by the number of premiums paid. A claimant is permitted to recover upon multiple policies for which multiple uninsured motorist premiums have been paid. However, the claimant may not recover unless he or she is an "insured," and the terms of the contract determine who is insured thereunder. The occupants of an insured motor vehicle involved in an accident, who are entitled to uninsured motorist coverage solely because of their status as passengers, may not stack the uninsured motorist coverage under separate policies purchased by the owner of the involved vehicle for a noninvolved vehicle or vehicles unless those passengers also qualify as insureds under those separate policies. (OK 2005) Withrow v. Pickard, 905 P.2d 800 (OK 1995) Scott v. Cimarron Ins. Co., 774 P.2d 456 (OK 1989) Babcock v. Adkins, 695 P.2d 1340 (OK 1984) UM/UIM Offset No. Liability limits do not reduce the UIM limits. UIM coverage is excess over the liability limits and UIM claim can be made when the insurance held by at-fault driver is insufficient to fully compensate for the injured party's losses. (F) The insurer making such payment shall not be entitled to any right of recovery against such tortfeasor in excess of the proceeds recovered from the assets of the insolvent insurer of said tortfeasor. Provided, however, with respect to payments made by reason of the coverage described in subsection C of this section, the insurer making such payment shall not be entitled to any right of recovery against such tortfeasor in excess of the proceeds recovered from the assets of the insolvent insurer of said tortfeasor.Provided further, that any payment made by the insured tortfeasor shall not reduce or be a credit against the total liability limits as provided in the insured's own uninsured motorist coverage. Provided further, that if a tentative agreement to settle for liability limits has been reached with an insured tortfeasor, written notice shall be given by certified mail to the uninsured motorist coverage insurer by its insured. Under the provisions of 36 O.S. §3636, uninsured motorist (UM) coverage is primary, meaning that an uninsured motorist carrier is liable for the entire amount of its insured's loss from the first dollar up to the UM policy limits without regard to the presence of any other insurance. The underinsurer is directly and primarily responsible to the insured for that amount of the claim which exceeds the liability limits of the tortfeasor's insurance. The insured may proceed against the underinsurer without first adjudicating the liability issues against the tortfeasor. 36 O.S. §3636 Uninsured Motorist Coverage Burch v. Allstate Ins. Co., 977 P.2d 1057 (OK 1998) Buzzard v. Farmers Ins. Co., Inc., 824 P.2d 1105 (OK 1991) Statute of Limitations 5 years. An action on a claim for recovery of uninsured/underinsured motorist benefits is a contract actions and will have a statute of limitations of 5 years. The statute of limitations begins to run when a breach of the insurance contract occurs, rather than the date of the accident. 12 O.S. §95 Limitation of Other Actions Wille v. Geico Casualty Co., 2 P.3d 888 (OK 2000) No Pay, No Play Law No Pay, No Play Law • Unconstitutional Montgomery v. Potter, 341 P.3d 660 (OK 2014) Communication Time Limits Days to Provide Necessary Claim Forms • Within 30 days from notice of claim, include instructions and reasonable assistance 36 O.S. §1250.6 Acknowledgement of Receipt of Claim -- Provisions for Claim Forms, Instruction, and Reasonable Assistance
- 3. 36 O.S. §1250.5 Actsby an Insurer Constituting an Unfair Claim Settlement Practice 36 O.S. §3629 Furnishing of Proof of Loss Forms - Submitting Written Offer of Settlement or Rejection of Claim to Insured Days to Acknowledge Claim • Within 30 days from notice of claim, unless payment made within that time • Acknowledgments not in writing must be noted in claim file 36 O.S. §1250.6 Acknowledgement of Receipt of Claim -- Provisions for Claim Forms, Instruction, and Reasonable Assistance 36 O.S. §1250.5 Acts by an Insurer Constituting an Unfair Claim Settlement Practice Days to Respond to Correspondence • 1st/3rd party policy limits: no provision • Within 30 days from receipt, supply adequate response 36 O.S. §1250.4 Claim Files -- Inquiries -- Responses -- Time Limit for Response Days to Accept or Deny • 1st party: Within 60 business days from proof of loss, unless fraud is reasonably suspected • Notify claimant and provide an explanation if more time needed • 3rd party: Not specified 36 O.S. §1250.7 Acceptance or Denial of Claim 36 O.S. §1250.5 Acts by an Insurer Constituting an Unfair Claim Settlement Practice 36 O.S. §3629 Furnishing of Proof of Loss Forms - Submitting Written Offer of Settlement or Rejection of Claim to Insured Disaster or Catastrophic Event Compliance Requirements • Insurance Commissioner may extend time for acceptance or denial of 1st party claims and claim investigations by 20 days during weather-related catastrophe • May pay claims by methods other than draft or check if conditions met 36 O.S. §1250.7 Acceptance or Denial of Claim OK BULLETIN NO. PC 2014-03-2 DISASTER PLANNING, PREPAREDNESS AND RESPONSE
- 4. Oklahoma Compliance Overview 2/19/202112:16:18 PM Aftermarket Parts Guidelines • Parts must have visible identifying logo or name; cannot specify use unless written notification given • When used written estimate must identify parts and include disclosure statement as required by provision 15 O.S. §952, et seq. Aftermarket Crash Parts Regulation Act Anti-steering (Repair and Glass Shop Law) Allowed to require repair or glass shop • Cannot require specific vehicle or glass repair shop 36 O.S. §1250.8 Methods to Apply for Adjustment and Settlement of Motor Vehicle Total Losses Diminution Diminution Allowed for 1st Party • Policy language will control • If repairable, recovery is difference between fair market value before and after collision • If total loss, recovery is fair market value in condition it was in before accident National Farmers Union Property & Casualty Co. v. Watson, 298 P.2d 762 (OK 1956) Phoenix Ins. Co., Hartford, Conn. v. Diffie, 270 P.2d 634 (OK 1954) Diminution Allowed for 3rd Party • Yes 23 O.S. §61 Breach of Obligation not Arising from Contract -- Measure of Damages Brennen v. Aston, 84 P.3d 99 (OK 2003) Disclosure of Personal or Privileged Information Disclosure of Personal or Privileged Information • Requirements for notice and opt out do not apply if disclosure is to effect or administer a transaction that consumer requests or authorizes • Disclosure is allowed if necessary to process insurance claims • Non-public health information may be disclosed for claims administration and management Okla. Admin. Code sect. 365:35-1-31 Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Processing and Servicing Transactions Okla. Admin. Code sect. 365:35-1-40 When Authorization Required for Disclosure of Nonpublic Personal Health Information Driving Under the Influence (DUI) Driving Under the Influence (DUI) • BAC of .08 or more at time of test w/in 2 hrs of arrest • Under influence of alcohol, controlled substance, or combination of both 47 O.S. §11-902 Persons Under the Influence of Alcohol or Other Intoxicating Substance or Combination Thereof
- 5. Adjuster Licensing Staff Adjuster- License Required • Yes 36 O.S. §6203 People Deemed Not to be Adjusters or Required to Obtain License as Adjusters Staff Adjuster - Catastrophe Adjuster Requirements • Applicant for license during emergency must be certified by an adjuster licensed in OK or insurer • May only adjust claims related to catastrophe • Does not have to be licensed adjuster • Insurer certifying applicant is still responsible for losses caused or improper claims handling practices • Employer must certify application to Commissioner within 5 days after begins working as emergency adjuster • Emergency adjuster license effective no more than 90 days from date emergency declaration issued but may be extneded an additional 90 days at Commissioner's discretion OK DOI Directives -- COVID-19 OK DOI Directives -- Winter Storms 36 O.S. §6218 Catastrophes Independent Adjuster - License Required • Yes 36 O.S. §6203 People Deemed Not to be Adjusters or Required to Obtain License as Adjusters Independent Adjuster - Catastrophe Adjuster Requirements • Applicant for license during emergency must be certified by an adjuster licensed in OK or insurer • May only adjust claims related to catastrophe • Does not have to be licensed adjuster • Insurer certifying applicant is still responsible for losses caused or improper claims handling practices • Employer must certify application to Commissioner within 5 days after begins working as emergency adjuster • Emergency adjuster license effective no more than 90 days from date emergency declaration issued but may be extneded an additional 90 days at Commissioner's discretion OK DOI Directives -- COVID-19 OK DOI Directives -- Winter Storms 36 O.S. §6218 Catastrophes Fraud Mandatory Reporting Requirements Required. General: A. If an insurer believes that any person or entity has engaged in fraudulent or illegal activities, the insurer is obligated to report such activities to the Anti-Fraud Unit of the Insurance Department. 36 O.S. §363 Reporting Suspected Fraud - Grant of Immunity Motor Vehicle: B. An insurer or an agent authorized by an insurer to act on its behalf shall notify the authorized governmental agency if the insurer or agent: 1. Knows the identity of a person whom the insurer or agent has reason to believe committed a criminal or fraudulent act relating to a motor vehicle theft or motor vehicle insurance claim; or 2. Has knowledge of a criminal fraudulent act relating to a motor vehicle theft or motor vehicle insurance claim that is reasonably believed not to have been reported to an authorized governmental agency. 74 O.S. §150.7c Release of Relevant Information - Notification to Authorized Governmental Agency Arson: B. When an insurance company has reason to believe that a fire loss in which it has an interest may be of other than accidental cause, the company shall in writing notify an authorized agency and provide it with all information, documents and evidence relating to the company's inquiry into the fire loss, for the purpose of having such fire loss investigated. 36 O.S. §6303 Release of Relevant Information - Information Included NICB Guest Statute Guest Statute • No provision No provision
- 6. Loss of Use(Rental) Third Party Loss of Use Required • Required • The insurance company for the at fault party should provide you with a replacement vehicle while your car is in the shop being repaired. If your car is a total loss, the company will generally provide the replacement vehicle until a settlement offer has been made on your car. On the other hand, if the accident was your fault and you will be filing a claim under your auto policy, a replacement car will not be provided unless you purchased rental reimbursement coverage. (OK DOI Consumer Assistance) 47 O.S. §7-103 Definitions OK DOI Consumer Assistance Vehicle Type • No provision No provision Named Driver Exclusion Named Driver Exclusion • Recognized • May exclude any person designated by name subject to minimum limits • Excluded driver must be covered by minimum limits 47 O.S. §7-324 Motor vehicle liability policies - contents and coverage Hartline v. Hartline, 39 P.3d 765 (OK 2001) Exceptions • Violates public policy if denies liability coverage to innocent 3rd parties • Exclusion violates public policy and unenforceable if based solely on driver's age under 18 McElmurry v. Garbow, 116 P.3d 198 (OK 2005) Mulford v. Neal, 264 P.3d 1173 (OK 2011) Rental Vehicles - Primary/Secondary Primacy • Owner of vehicle may submit a valid binding lease contract between the owner and renter wherein it is agreed that the renter accepts responsibility for loss from any liability imposed by law 47 O.S. §8-101 Owner of For-Rent Vehicle to Give Proof of Financial Responsibility Salvage/Valuation/Disputes Settlement Methods • ACV or Replacement vehicle 36 O.S. §1250.8 Methods to Apply for Adjustment and Settlement of Motor Vehicle Total Losses Valuation Methods Permitted • Replacement must be a specific available comparable vehicle, including taxes and fees, minus deductible - 1st party • Offer and rejection must be documented • Cash settlement based on actual cost or comparable vehicle, minus deductible and including taxes and fees - 1st party • If other method used, must support with documentation • Fair market value is value listed in current guidebook or ACV, whichever is greater 36 O.S. §1250.8 Methods to Apply for Adjustment and Settlement of Motor Vehicle Total Losses 47 O.S. §1111 Payment of Total Loss Claim - Certificate of Title Total Loss Settlements Threshold • Noneconomic • Within last 10 model years with actual repair costs greater than 60% 47 O.S. §1105 Definitions Taxes/Fees* • Note - Information provided on this page should not be used to calculate total loss claims. Other variables will apply. • Taxes/Fees: 1st party owed 36 O.S. §1250.8 Methods to Apply for Adjustment and Settlement of Motor Vehicle Total Losses
- 7. *The tax andfee information provided above is intended to offer general information and does not encompass exact fees owed in total loss settlements. In addition, your company's policy may alter whether or not certain taxes or fees are owed or not owed. Active Emergency Orders - OK DOI Directives -- COVID-19 Effective Dates • COVID-19 - 03/15/2020 thru 03/14/2021 Executive Order 2021-07 Executive Order 2021-07 Ninth Amended Executive Order 2020-20 Eighth Amended Executive Order 2020-20 Seventh Amended Executive Order 2020-20 Sixth Amended Executive Order 2020-20 Fifth Amended Executive Order 2020-20 Fourth Amended Executive Order 2020-20 Third Amended Executive Order 2020-20 Second Amended Executive Order 2020-20 Amended Executive Order 2020-20 Amended Executive Order 2020-20 Executive Order 2020-20 Sixth Amended Executive Order 2020-13 Fifth Amended Executive Order 2020-13 Fourth Amended Executive Order 2020-13 Third Amended Executive Order 2020-13 Second Amended Executive Order 2020-13 Second Amended Executive Order 2020-13 Amended Executive Order 2020-13 Executive Order 2020-13 Eighth Amended Executive Order 2020-07 Seventh Amended Executive Order 2020-07 Sixth Amended Executive Order 2020-07 Fifth Amended Executive Order 2020-07 Fourth Amended Executive Order 20-07 Fourth Amended Executive Order 2020-07 Third Amended Executive Order 2020-07 Second Amended Executive Order 2020-07 Amended Executive Order 2020-07 Executive Order 2020-07 Executive Order 2020-07 See also: Executive Order 2020-07 Executive Order 2020-07
- 8. Event • COVID-19 Executive Order2021-07 Executive Order 2021-07 Counties Affected • Statewide Executive Order 2021-07 Executive Order 2021-07 See also: Commissioner Letter to Oklahomans - 04/14/2020 We're All In This Together PROMETRIC COVID-19 FAQs Catastrophe Adjuster Requirements • OK insurance exams available via remotely proctored testing • PROMETRIC testing centers reopened with 100% testing capacity w/ social distancing procedures • DOI has released modified license exams DOI Special Notice - 08/06/2020 Launch of Prometric’s ProProctor™ Online Proctoring Solution DOI Special Notice - 06/02/2020 Testing Centers DOI Notice - 05/28/2020 Oklahoma Insurance Licensing Exam DOI Special Notice - 05/15/2020 (Updated) Testing Centers and Temporary License Information OK DOI PL Bulletin 2020-02 Temporary Producer and Apprentice Adjuster Licenses/Process DOI Special Notice - 06/18/2020 Temporary Producer and Apprentice Adjuster License Applications and Expiration Eighth Amended Executive Order 2020-20 See also: Commissioner Letter to Oklahomans - 04/14/2020 We're All In This Together Claims Handling Guidelines/Guidance • Insurers must - • Quickly respond to inquiries • Streamline responses/benefits • Suspend claims reporting deadlines • Accept e-sig or e-notary as valid and binding, on any claim or claim related doc • Effective 06/30/2020 - • The previous requirement to suspend/extend policyholder rights/benefits for deadlines until 90 days after emergency is rescinded • The term previously afforded is allowed to expire upon reaching the end of the extension OK Bulletin No. PC 2020-01 (Updated on June 18, 2020) Coronavirus (COVID-19) OK Bulletin No. PC 2020-01 (Amended) Coronavirus (COVID-19) See also: Commissioner Letter to Oklahomans - 04/14/2020 We're All In This Together Company Reporting Requirements • Insurers still required to make all required electronic filings with the NAIC or to assigned analyst, but may allow add'l 30/60 day extension upon request • Hard copy, original signature, and related filing requirements currently waived • Insurer expected to keep list of e-filings to f/u with hard copy w/in 60 days after allowed to return to work • No on-site exams are being conducted and DOI will request more info via electronic form • DOI knows insurer response times will be slower • Insurers must - • Review internal processes/continuity of operations • Provide timely access to services • Continually assess readiness • Make info available on websites/staff help lines accordingly OK DOI Financial Bulletin 2020-02 Complying With Regulatory Requirements During the COVID-19 Public Health Emergency OK Bulletin No. PC 2020-01 (Amended) Coronavirus (COVID-19) OK Bulletin No. PC 2020-01 Coronavirus (COVID-19) OK DOI Communication (Claim Toolkit correspondence with DOI. For additional information contact Claim Toolkit Help Desk) Company Underwriting Guidelines/Guidance • Effective 06/30/2020 - • Grace periods can expire upon reaching the end of the extension period previously provided to the OK Bulletin No. PC 2020-01 (Updated on June 18, 2020) Coronavirus (COVID-19)
- 9. insured • Insurers whoissued policies that provide coverage to commercial insureds whose policy is rated under an auditable exposure basis - • Insurer has right to demand midterm self audit and insurer must honor demand and assist in audit until end of 2020 • Insurer must adjust premium if in excess of current rating variables and make refund of overpymt within 10 days of audit • Insurer retains right to conduct physical audit and immediately transmit results to insured • DOI working diligently to approve insurer relief programs OK Bulletin No. PC 2020-01 (Amended) Coronavirus (COVID-19) OK Bulletin No. PC 2020-01 Coronavirus (COVID-19) OK Bulletin No. PC 2020-03 (Corrected) Auditable Insurance Policy Bulletin OK DOI Notice - 04/17/2020 Insurance Commissioner Recognizes Industry Efforts to Provide Premium Relief During COVID-19 Policy/Regulatory Changes • Governor suspends fees/costs for oversize/overweight permits related to the transport of COVID-19 related relief efforts • Motor carriers and drivers providing direct assistance for COVID-19 relief efforts are awarded regulatory relief related to limitation on hours of service Executive Order 2020-13 Eighth Amended Executive Order 2020-20 Active Emergency Orders - State of Emergency due to Winter Storms Effective Dates • Winter Storms - 02/12/2021 - 03/14/2021 Executive Order 2021-06 Event • Severe winter weather/storms Executive Order 2021-06 Counties Affected • Statewide Executive Order 2021-06 Catastrophe Adjuster Requirements • 02/17/2021 - emergency licenses may be issued to adjust cat event • Emergency adjuster license valid for 90 days from issuance, unless extended for 90 days by DOI OK DOI - Case No. 21-0077-EMG Declaration of Emergency Pursuant to Section 6218 of the Oklahoma Insurance Code Claims Handling Guidelines/Guidance • No provision No provision Company Reporting Requirements • No provision No provision Company Underwriting Guidelines/Guidance • No provision No provision Policy/Regulatory Changes • Oversize/overweight requirements/costs/fees temporarily suspended • Propane shortage - drivers exempt from certain FMCSA regs • Dealers exempt from regs re: filling other company tanks if tank 10% or less Executive Order 2021-06 Amended Executive Order 2021-04 Executive Order 2021-04 The information contained herein is publicly available and organized by us solely for general information purposes. While we make all reasonable attempts and endeavor to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability with respect to the information contained herein. Because this content is frequently changed with or without notice, printed versions of the material contained herein are not guaranteed to be complete, correct, timely, current or up-to-date. Therefore, reliance solely on such printed materials is not recommended and done only at the user's sole risk. The presentation of this information is not legal advice, nor should it be used to substitute or replace the legal judgment, operating procedures, decisions, rules, guidelines, or advice of your Affiliated Companies. This page may also contain various links to other websites which are not under the control of Claim Toolkit. We have no control over the nature, content, and availability of those sites. The inclusion of links to these sites does not imply a recommendation or endorsement of the views expressed therein.