Section 0780-01-54-.20 - EXAMINATIONS AND INVESTIGATIONS(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; or3. 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.Tenn. Comp. R. & Regs. 0780-01-54-.20
Original rule filed April 8, 1986; effective May 8, 1986. Repeal and new rule filed August 31, 2005; effective November 14, 2005. Amendment filed December 31, 2008; effective March 16, 2009.Authority: T.C.A. §§ 50-6-405(c) and (h), 56-1-204, 56-1-408, 56-1-409(b)(5), 56-1-411 and 56-1-413.