Payment of claims, fiduciary duties of TPA

1. Law
2. US Virgin Islands Code
3. Insurance
4. Third Party Administrators
5. Payment of claims, fiduciary duties of TPA

• The TPA is the trustee for all money that is received to pay claims and claim adjustment expenses. All claim moneys must be deposited in a special fiduciary account in a financial institution that is located in the Virgin Islands. The special fiduciary account must be designated as a CASA. All claims paid by the TPA from funds collected on behalf of or for a payor must be paid only as authorized by the payor. Payments from an account maintained or controlled by the TPA for purposes including the payment of claims must be made only for the following purposes:

  • (1) payment of valid claims;

  • (2) payment of expenses associated with claims handled by the TPA or to other service providers approved by the payor;

  • (3) remittance to the payor, or transfer to a successor TPA, as directed by the payor, for the purpose of paying claims and associated expenses; or

  • (4) return of funds held as collateral or prepayment to the person entitled to those funds, upon a determination by the payor that those funds are no longer necessary to secure or facilitate the payment of claims and associated expenses.

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