Hearing, insurer's right to, when — procedures — judicial review of order, exceptions.

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Effective - 28 Aug 2014

375.1265. Hearing, insurer's right to, when — procedures — judicial review of order, exceptions. — 1. Upon:

(1) Notification to an insurer or health organization by the director of an adjusted RBC report; or

(2) Notification to an insurer or health organization by the director that:

(a) The insurer's or health organization's RBC plan or revised RBC plan is unsatisfactory; and

(b) Such notification constitutes a regulatory action level event with respect to such insurer or health organization; or

(3) Notification to any insurer or health organization by the director that the insurer or health organization has failed to adhere to its RBC plan or revised RBC plan and that such failure has a substantial adverse effect on the ability of the insurer or health organization to eliminate the company action level event with respect to the insurer or health organization in accordance with its RBC plan or revised RBC plan; or

(4) Notification to an insurer or health organization by the director of a corrective order with respect to the insurer or health organization;

­­the insurer or health organization shall have the right to a confidential departmental hearing, with a record made, at which the insurer or health organization may challenge any determination or action by the director. The insurer or health organization shall notify the director of its request for a hearing within five days after the notification by the director pursuant to this subsection. Upon receipt of the insurer's or health organization's request for a hearing, the director shall set a date for the hearing, which date shall be no less than ten nor more than thirty days after the date of the insurer's or health organization's request.

2. An insurer or health organization aggrieved by an order of the director after a hearing pursuant to subsection 1 of this section may obtain judicial review of such order pursuant to sections 536.100 to 536.140, except that:

(1) No insurer or health organization shall be deemed aggrieved unless the director has either:

(a) Made the director's order public; or

(b) Taken action pursuant to sections 375.1250 to 375.1275 or pursuant to sections 375.1165 to 375.1246; or

(c) Issued a corrective order after the hearing;

(2) If the director has taken action as described in paragraph (b) of subdivision (1) of subsection 1 of this section, judicial review pursuant to this section shall be consolidated with and be pendent to the action pursuant to the director's action.

3. There shall be no judicial review of any action by the director pursuant to sections 375.1250 to 375.1275 except as provided in subsection 2 of this section.

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(L. 1993 H.B. 709 § 7, A.L. 1996 S.B. 759, A.L. 2014 H.B. 1968)


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