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90_HB1552eng 215 ILCS 5/534.3 from Ch. 73, par. 1065.84-3 215 ILCS 5/534.4 from Ch. 73, par. 1065.84-4 215 ILCS 5/538.4 from Ch. 73, par. 1065.88-4 215 ILCS 5/545 from Ch. 73, par. 1065.95 215 ILCS 5/546 from Ch. 73, par. 1065.96 Amends the Illinois Insurance Code. Provides that covered claim does not include certain third party claims against insurers. Repeals certain provisions concerning exhaustion of claims. Provides that an insured or claimant shall be required to first exhaust all coverage provided by any other insurance policy if the claim arises from the same facts, injury, or loss that gave rise to the covered claim against the Fund. Provides that the Fund's obligation shall be reduced by the amount recovered or recoverable, whichever is greater, under the other insurance policy. Provides that to the extent the Fund's obligation is reduced, the liability of the person insured by the insolvent insurer's policy for the claim shall be reduced in the same amount. Makes other changes. Effective immediately. LRB9004923LDdv HB1552 Engrossed LRB9004923LDdv 1 AN ACT to amend the Illinois Insurance Code by changing 2 Sections 534.3, 534.4, 538.4, 545, and 546. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Illinois Insurance Code is amended by 6 changing Sections 534.3, 534.4, 538.4, 545, and 546 as 7 follows: 8 (215 ILCS 5/534.3) (from Ch. 73, par. 1065.84-3) 9 Sec. 534.3. Covered claim; unearned premium defined. 10 (a) "Covered claim" means an unpaid claim for a loss 11 arising out of and within the coverage of an insurance policy 12 to which this Article applies and which is in force at the 13 time of the occurrence giving rise to the unpaid claim, 14 including claims presented during any extended discovery 15 period which was purchased from the company before the entry 16 of a liquidation order or which is purchased or obtained from 17 the liquidator after the entry of a liquidation order, made 18 by a person insured under such policy or by a person 19 suffering injury or damage for which a person insured under 20 such policy is legally liable, and for unearned premium, if: 21 (i) The company issuing the policy becomes an 22 insolvent company as defined in Section 534.4 after the 23 effective date of this Article; and 24 (ii) The claimant or insured is a resident of this 25 State at the time of the insured occurrence, or the 26 property from which a first party claim for damage to 27 property arises is permanently located in this State or, 28 in the case of an unearned premium claim, the 29 policyholder is a resident of this State at the time the 30 policy was issued; provided, that for entities other than 31 an individual, the residence of a claimant, insured, or HB1552 Engrossed -2- LRB9004923LDdv 1 policyholder is the state in which its principal place of 2 business is located at the time of the insured event. 3 (b) "Covered claim" does not include: 4 (i) any amount in excess of the applicable limits 5 of liability provided by an insurance policy to which 6 this Article applies; nor 7 (ii) any claim for punitive or exemplary damages; 8 nor 9 (iii) any first party claim by an insured who is an 10 affiliate of the insolvent company; nor 11 (iv) any first party or third party claim by or 12 against an insured whose net worth on December 31 of the 13 year next preceding the date the insurer becomes an 14 insolvent insurer exceeds $25,000,000$50 million; 15 provided that an insured's net worth on such date shall 16 be deemed to include the aggregate net worth of the 17 insured and all of its affiliates as calculated on a 18 consolidated basis. However, this exclusion shall not 19 apply to third party claims against the insured where the 20 insured has applied for or consented to the appointment 21 of a receiver, trustee, or liquidator for all or a 22 substantial part of its assets, filed a voluntary 23 petition in bankruptcy, filed a petition or an answer 24 seeking a reorganization or arrangement with creditors or 25 to take advantage of any insolvency law, or if an order, 26 judgment, or decree is entered by a court of competent 27 jurisdiction, on the application of a creditor, 28 adjudicating the insured bankrupt or insolvent or 29 approving a petition seeking reorganization of the 30 insured or of all or substantial part of its assets; nor 31 (v) any claim for any amount due any reinsurer, 32 insurer, insurance pool, or underwriting association as 33 subrogated recoveries, reinsurance recoverables, 34 contribution, indemnification or otherwise. No such claim HB1552 Engrossed -3- LRB9004923LDdv 1 held by a reinsurer, insurer, insurance pool, or 2 underwriting association may be asserted in any legal 3 action against a person insured under a policy issued by 4 an insolvent company other than to the extent such claim 5 exceeds the Fund obligation limitations set forth in 6 Section 537.2 of this Code. 7 (c) "Unearned Premium" means the premium for the 8 unexpired period of a policy which has been terminated prior 9 to the expiration of the period for which premium has been 10 paid and does not mean premium which is returnable to the 11 insured for any other reason. 12 (Source: P.A. 89-97, eff. 7-7-95.) 13 (215 ILCS 5/534.4) (from Ch. 73, par. 1065.84-4) 14 Sec. 534.4. "Insolvent company" means a company 15 organized as a stock company, mutual company, reciprocal or 16 Lloyds (a) which holds a certificate of authority to transact 17 insurance in this State either at the time the policy was 18 issued or when the insured event occurred, or any company 19 which has assumed such policy obligation through merger, 20 consolidation or reinsurance, whether or not such assuming 21 company held a certificate of authority to transact insurance 22 in this State at the time such policy was issued or when the 23 insured event occurred; and (b) against which a finalan24 Order of Liquidation with a finding of insolvency to which 25 there is no further right of appeal has been entered by a 26 court of competent jurisdiction in the company's State of 27 domicile after the effective date of this Article, and which28Order of Liquidation has not been stayed or been the subject29of a writ or supersedeas or other comparable order. 30 (Source: P.A. 85-576.) 31 (215 ILCS 5/538.4) (from Ch. 73, par. 1065.88-4) 32 Sec. 538.4. Legal actions by Fund. The Fund may sue or HB1552 Engrossed -4- LRB9004923LDdv 1 be sued, including taking any legal actions necessary or 2 proper for recovery of any unpaid assessments under Sections 3 537.1 or 537.6. The Fund's power to sue includes, but is not 4 limited to, the power and right to intervene as a party 5 before any court that has jurisdiction over an insolvent 6 insurer when the Fund is a creditor or potential creditor of 7 the insolvent insurer. 8 (Source: P.A. 89-97, eff. 7-7-95.) 9 (215 ILCS 5/545) (from Ch. 73, par. 1065.95) 10 Sec. 545. Effect of paid claims. 11 (a) Every insured or claimant seeking the protection of 12 this Article shall cooperate with the Fund to the same extent 13 as such person would have been required to cooperate with the 14 insolvent company. The Fund shall have all the rights, duties 15 and obligations under the policy to the extent of the covered 16 claim payment, provided the Fund shall have no cause of 17 action against the insured of the insolvent company for any 18 sums it has paid out except such causes of action as the 19 insolvent company would have had if such sums had been paid 20 by the insolvent company and except as provided in paragraph 21 (d) of this Section. 22 (b) The Fund and any similar organization in another 23 state shall be recognized as claimants in the liquidation of 24 an insolvent company for any amounts paid by them on covered 25 claims obligations as determined under this Article or 26 similar laws in other states and shall receive dividends at 27 the priority set forth in paragraph (d) of subsection (1) of 28 Section 205 of this Code. The liquidator of an insolvent 29 company shall be bound by determinations of covered claim 30 eligibility under the Act and by settlements of claims made 31the amounts of covered claim paymentsby the Fund or a 32 similar organization in another state on the receipt of 33 certification of such payments, to the extent those HB1552 Engrossed -5- LRB9004923LDdv 1 determinations or settlements satisfy obligations of the 2 Fund, but the receiver shall not be bound in any way by those 3 determinations or settlements to the extent that there 4 remains a claim in the estate for amounts in excess of the 5 payments by the Fund. In submitting their claim for covered 6 claim payments the Fund and any similar organization in 7 another state shall not be subject to the requirements of 8 Sections 208 and 209 of this Code and shall not be affected 9 by the failure of the person receiving a covered claim 10 payment to file a proof of claim. 11 (c) The expenses of the Fund and of any similar 12 organization in any other state, other than expenses incurred 13 in the performance of duties under Section 547 or similar 14 duties under the statute governing a similar organization in 15 another state, shall be accorded the same priority as the 16 liquidator's expenses. The liquidator shall make prompt 17 reimbursement to the Fund and any similar organization for 18 such expense payments. 19 (d) The Fund has the right to recover from the following 20 persons the amount of any covered claims and allocated claims 21 expenses which the Fund paid or incurred on behalf of such 22 person in satisfaction, in whole or in part, of liability 23 obligations of such person to any other person: 24 (i) any insured whose net worth on December 31 of 25 the year next preceding the date the company becomes an 26 insolvent company exceeds $25,000,000$50 million; 27 provided that an insured's net worth on such date shall 28 be deemed to include the aggregate net worth of the 29 insured and all of its affiliates as calculated on a 30 consolidated basis. 31 (ii) any insured who is an affiliate of the 32 insolvent company. 33 (Source: P.A. 89-206, eff. 7-21-95.) HB1552 Engrossed -6- LRB9004923LDdv 1 (215 ILCS 5/546) (from Ch. 73, par. 1065.96) 2 Sec. 546. Other insurance.Non-duplication of recovery.3 (a) An insured or claimant shall be required first to 4 exhaust all coverage provided by any other insurance policy, 5 regardless of whether or not such other insurance policy was 6 written by a member company, if the claim under such other 7 policy arises from the same facts, injury, or loss that gave 8 rise to the covered claim against the Fund. The Fund's 9 obligation under Section 537.2 shall be reduced by the amount 10 recovered or recoverable, whichever is greater, under such 11 other insurance policy. Where such other insurance policy 12 provides uninsured or underinsured motorist coverage, the 13 amount recoverable shall be deemed to be the full applicable 14 limits of such coverage. To the extent that the Fund's 15 obligation under Section 537.2 is reduced by application of 16 this Section, the liability of the person insured by the 17 insolvent insurer's policy for the claim shall be reduced in 18 the same amount.Any insured or claimant having a covered19claim against the Fund shall be required first to exhaust his20rights under any provision in any other insurance policy21which may be applicable to the claim, whether or not the22insurance policy was written by a member company. Any amount23payable on a covered claim under this Article shall be24reduced by the amount of such recovery under such insurance25policy.26 (b) Any insured or claimant having a claim which may be 27 recovered under more than one insurance guaranty fund or its 28 equivalent shall seek recovery first from the Fund of the 29 place of residence of the insured except that if it is a 30 first party claim for damage to property with a permanent 31 location, he shall first seek recovery from the Fund of the 32 location of the property; if it is a workers' compensation 33 claim, he shall first seek recovery from the Fund of the 34 residence of the claimant. Any recovery under this Article HB1552 Engrossed -7- LRB9004923LDdv 1 shall be reduced by the amount of the recovery from any other 2 insurance guaranty fund or its equivalent. 3 (Source: P.A. 89-97, eff. 7-7-95.) 4 Section 99. Effective date. This Act takes effect upon 5 becoming law.