(1) The
Commissioner has the authority to examine the affairs of any pool that has
applied for or received a certificate of authority under this Chapter in order
to determine the financial condition of the pool or to determine whether the
pool is in compliance with all insurance laws and regulations applicable to it.
Such examinations shall be conducted when deemed necessary but no less than
once every five (5) years, and all expenses of such examinations shall be
assessed against the pool, including the costs of contract examiners or
specialists. T.C.A. §
56-1-411 provides the standard for
examination reports and procedure. The following procedure will be applied to
pools:
(a) No later than sixty (60) days
following completion of the examination, the examiner in charge shall file with
the Department a verified written report of examination under oath. Upon
receipt of the verified report, the Department shall transmit the report to the
pool examined, together with a notice which shall afford the pool examined a
reasonable opportunity of not more than sixty (60) days to make a written
submission or rebuttal with respect to any matters contained in the examination
report.
(b) Within thirty (30) days
of the end of the period allowed for the receipt of written submission or
rebuttals, the Commissioner shall fully consider and review the report,
together with any written submissions or rebuttals and any relevant portions of
the examiner's work papers and enter an order:
1. Adopting the examination report as filed
or with modifications or corrections. If the examination report reveals that a
pool is operating in violation of any law, regulation, or prior order of the
Commissioner, the Commissioner may order the pool to take any action the
Commissioner considers necessary and appropriate to cure such
violations;
2. Rejecting the
examination report with directions to the examiners to reopen the examination
for purposes of obtaining additional data, documentation or information, and
re-filing; or
3. Calling for an
investigatory hearing with no less than twenty (20) days notice to the pool for
purposes of obtaining additional documentation, data, information or
testimony.
(c) If the
examination reveals that the pool is operating in violation of any law,
regulation or prior order, the Commissioner in such written order may require
the pool to take any action the Commissioner considers necessary or appropriate
in accordance with the report of examination or the hearing, if any, on such.
That order shall be subject to judicial review in accordance with the
provisions of Title 27, Chapter 9.
(d) All working papers, recorded information,
documents and copies thereof produced by, obtained by or disclosed to the
Commissioner or his/her designee in the course of an examination made under
this Rule must be given confidential treatment and may not be made public by
the Commissioner or his/her designee, except as to those uses provided in
T.C.A. §§
56-1-411 and
50-6-405(c).
(2) The Commissioner has the
authority to investigate the affairs of any person acting as a pool or any
person associated or affiliated with a pool that offers or proposes to offer
workers' compensation insurance in this State in order to determine whether
such person is in violation of the Tennessee Insurance Law or this
Chapter.
