North Carolina Administrative Code

11 NCAC 01 .0209 INSTRUCTIONS FOR FILING A PETITION FOR RULE-MAKING (a) Any person may petition the Department to adopt a new rule, or amend or repeal an existing rule by submitting a rulemaking petition to the Department. The petition must be titled "Petition for Rulemaking", mu…

SECTION .0300 - DECLARATORY RULINGS 11 NCAC 01 .0301 DECLARATORY RULINGS: GENERAL INFORMATION (a) Declaratory rulings pursuant to G.S. 150B-4 shall be issued by the Department only: (1) as to the validity of a rule adopted by the Department; or (2) as to the applicability to a gi…

11 NCAC 01 .0302 PETITION FOR DECLARATORY RULING (a) Petitioner Must Possess Interest. The petitioner must possess such an interest in the question to be ruled on that the petitioner's need to have such a ruling in order to comply with statutory requirements, departmental rules, …

11 NCAC 01 .0303 RESPONSE OF COMMISSIONER TO PETITION (a) Written Response. A written response to the petition for a declaratory ruling, whether in the form of a declaratory ruling or a refusal to issue a declaratory ruling, shall be signed by the commissioner or his designated r…

SECTION .0400 - ADMINISTRATIVE HEARINGS 11 NCAC 01 .0401 RIGHT TO HEARING Whenever the Department acts in such a way as to affect the rights, duties or privileges of a specific identified party, the party may appeal for a final decision by the Department in accordance with this S…

11 NCAC 01 .0402 INFORMAL SETTLEMENT History Note: Authority G.S. 58-2-40; Eff. February 1, 1976; Readopted Eff. May 12, 1978; Repealed Eff. August 3, 1992.

11 NCAC 01 .0403 REQUEST FOR HEARING (a) A request for an administrative hearing under 11 NCAC 01 .0401 must be in writing and shall contain the following information: (1) name and address of the person requesting the hearing, (2) a statement of the departmental action being chal…

11 NCAC 01 .0404 GRANTING OR DENYING HEARING REQUESTS History Note: Authority G.S. 158-9; Eff. February 1, 1976; Readopted Eff. May 12, 1978; Repealed Eff. September 1, 1988.

11 NCAC 01 .0405 NOTICE OF HEARING History Note: Authority G.S. 58-2-50; 150B-23; Eff. February 1, 1976; Readopted Eff. May 12, 1978; Repealed Eff. July 1, 1992.

11 NCAC 01 .0406 FAILURE TO APPEAR AT HEARING History Note: Authority G.S. 150B-39; Eff. February 1, 1976; Readopted Eff. May 12, 1978; Repealed Eff. September 1, 1988.

11 NCAC 01 .0412 APPEALS TO THE COMMISSIONER History Note: Authority G.S. 58-155.49, -155.83, -173.11, -173.23, -248.39; Eff. May 12, 1978; Repealed Eff. August 1, 1988.

11 NCAC 01 .0413 DEFINITIONS The definitions contained in G.S. 150B-2 are incorporated in this Section by reference. In addition to those definitions, the following definitions apply to this Section: (1) "File or filing" means to place or the placing of the paper or item to be fi…

11 NCAC 01 .0414 GENERAL PROVISIONS Governed by the principles of fairness, uniformity, and punctuality, the following general provisions apply to this Section: (1) The Rules of Civil Procedure as contained in G.S. 1A-1 and the General Rules of Practice for the Superior and Distr…

11 NCAC 01 .0415 ORDER FOR PREHEARING STATEMENTS The hearing officer may serve all parties with an order for prehearing statements together with, or after service of, the notice of hearing. Every party thus served shall, within 30 days after service, file the requested statements…

11 NCAC 01 .0416 DUTIES OF THE HEARING OFFICER In conjunction with the powers in this Section, in General Statute Chapter 58, and in Article 3A of General Statute Chapter 150B, the hearing officer shall perform the following duties, consistent with law: (1) Hear and rule on motio…

11 NCAC 01 .0417 CONSENT ORDER; SETTLEMENT; STIPULATION Informal disposition may be made of a contested case or an issue in a contested case by stipulation, agreement, or consent order at any time during the proceedings. Parties may enter into such agreements on their own or may …

11 NCAC 01 .0418 SETTLEMENT CONFERENCE (a) A settlement conference is for the primary purpose of assisting the parties in resolving disputes and for the secondary purpose of narrowing the issues and preparing for hearing. (b) Upon the request of any party, the hearing officer sha…

11 NCAC 01 .0419 PREHEARING CONFERENCE (a) The purpose of the prehearing conference is to simplify the issues to be determined; to obtain stipulations in regard to foundations for testimony or exhibits; to obtain stipulations of agreement on undisputed facts or the application of…

11 NCAC 01 .0420 CONSOLIDATION OF CASES (a) The hearing officer may order a joint hearing of any matters at issue in contested cases involving common questions of law or fact or multiple proceedings involving the same or related parties, or may order the cases consolidated or mak…

11 NCAC 01 .0421 DISCOVERY (a) Discovery methods are means designed to assist parties in preparing to meet their responsibilities and protect their rights during hearings without unduly delaying, burdening or complicating the hearings process and with due regard to the rights and…

11 NCAC 01 .0422 SUBPOENAS (a) Subpoenas for the attendance and testimony of witnesses or for the production of documents, either at a hearing or for the purposes of discovery, shall be issued in accordance with G.S. 150B-39(c) and G.S. 1A-1 Rule 45. (b) A subpoena shall be serve…

11 NCAC 01 .0423 SANCTIONS (a) If a party fails to appear at a hearing or fails to comply with an interlocutory order of the hearing officer, the hearing officer may: (1) Find that the allegations of or the issues set out in the notice of hearing or other pleading may be taken as…

11 NCAC 01 .0424 MOTIONS (a) Any application to the hearing officer for an order shall be by motion, which shall be in writing unless made during a hearing, and must be filed and served upon all parties not less than 10 days before the hearing, if any, is to be held either on the…

11 NCAC 01 .0425 INTERVENTION (a) Any person not named in the notice of hearing who desires to intervene in a contested case as a party shall file a motion to intervene and shall serve the motion upon all existing parties. The motion shall show how the movant's rights, duties, or…

11 NCAC 01 .0426 CONTINUANCES (a) As used in this Rule, "good cause" includes death or incapacitating illness of a party, representative, or attorney of a party; a court order requiring a continuance; lack of proper notice of the hearing; a substitution of the representative or a…

11 NCAC 01 .0427 RIGHTS AND RESPONSIBILITIES OF PARTIES (a) A party may present evidence, rebuttal testimony, and argument with respect to the issues of law and policy, and cross-examine witnesses, including the author of a document prepared by, on behalf of, or for use of the De…

11 NCAC 01 .0428 WITNESSES Any party may be a witness and may present witnesses on the party's behalf at the hearing. All oral testimony at the hearing shall be under oath or affirmation and shall be recorded. At the request of a party or upon the hearing officer's own motion, th…

11 NCAC 01 .0429 EVIDENCE (a) The North Carolina Rules of Evidence as found in Chapter 8C of the General Statutes govern in all contested case proceedings, except as provided otherwise in this Section and G.S. 150B-41. (b) The hearing officer may admit all evidence that has proba…

11 NCAC 01 .0430 OFFICIAL RECORD (a) The official record of a contested case is available for public inspection upon reasonable request. The hearing officer may, upon good cause shown and consistent with law, order part or all of an official record sealed. (b) The official record…

11 NCAC 01 .0431 RATEMAKING PROCEDURES FOR RATE BUREAU FILINGS History Note: Authority G.S. 58-2-40(1) ; 58-36-1; 58-36-10; 58-36-15; 58-36-20; 58-36-70; 150B-38; Eff. January 1, 1993; Repealed Eff. December 1, 1994.

SECTION .0600 - GENERAL DEPARTMENTAL POLICIES 11 NCAC 01 .0601 COMMUNICATIONS WITH INSURANCE COMPANIES It is the policy of this department, when deemed necessary, to communicate with insurance companies at company expense by means of collect telephone calls, telegrams, and other …

11 NCAC 01 .0602 INSURANCE COMPANIES' RESPONSE TO DEPARTMENTAL INQUIRIES Every insurer, upon receipt of an inquiry, oral or written, from the department shall furnish the commissioner or his designated representative with a complete and accurate response in writing, unless such r…

11 NCAC 01 .0603 FACSIMILE COUNTERSIGNATURE NOT VALID History Note: Authority G.S. 58-2-40; 58-33-30(i); 58-33-60; Eff. February 1, 1976; Readopted Eff. May 12, 1978; Amended Eff. July 1, 1992; August 1, 1988; Repealed Eff. July 1, 2012.

CHAPTER 3 - LEGAL DIVISION 11 NCAC 03 .0101 DEFINITIONS History Note: Authority G.S. 58-9; 150A-12(f); Eff. February 1, 1976; Readopted Eff. May 12, 1978; Amended Eff. June 1, 1985; Repealed Eff. July 1, 1988.

11 NCAC 03 .0102 PURPOSE OF DIVISION History Note: Authority G.S. 58-7.3; 58-9; Eff. February 1, 1976; Readopted Eff. May 12, 1978; Amended Eff. August 1, 1988; June 1, 1985; Repealed Eff. December 1, 1992.

11 NCAC 03 .0108 LEGAL OPINIONS History Note: Authority G.S. 58-7.3; 58-9; Eff. August 1, 1988; Repealed Eff. December 1, 1992.

11 NCAC 04 .0106 RULE FOR LOSS AND CLAIM PRACTICES AND PROCEDURES History Note: Authority G.S. 57-4; 57-10; 58-9; 58-9.2; 58-15; 58-25; 58-25.1; 58-26; 58-27; 58-40; 58-40.1; 58-128; Eff. February 1, 1976; Repealed Eff. March 8, 1978.

11 NCAC 04 .0107 SEX DISCRIMINATION IN INSURANCE History Note: Filed as an Emergency Repeal Eff. April 25, 1979, for a Period of 120 Days to be Reinstated on August 23, 1979; Authority G.S. 58-9; 58-44.3; 58-54.1; 58-54.13; Eff. May 5, 1977; Readopted Eff. March 16, 1979; Repeale…

11 NCAC 04 .0115 DIVISION PROCEDURES (a) Complaints arising from insurance products, companies, insurance agents, adjusters, brokers, producers, and motor vehicle damage appraisers regulated under G.S. Chapter 58 will be processed in the following manner: (1) The analyst will req…

11 NCAC 04 .0116 INQUIRIES AND INFORMATION The toll free telephone number for the Consumer Services Division is 1-855-408-1212. The mailing address of the Consumer Services Division is: North Carolina Department of Insurance, 1201 Mail Service Center, Raleigh, North Carolina 2769…

11 NCAC 04 .0117 STATEMENT OF ACTION (a) When an insurer denies a claim that included information for the insurer to identify the coverage involved, the denial shall be in writing and cite the policy provision or other legal basis used to deny the claim. (b) When an insurer offer…

11 NCAC 04 .0118 INSURANCE CARRIERS AS LENDERS (a) Any lender who offers an insurance product to a consumer either directly or indirectly through a subsidiary or affiliate in conjunction with an extension of credit shall inform the consumer of the protections afforded by G.S. 58-…

11 NCAC 04 .0119 INSURER DEFINED History Note: Authority G.S. 58-2-40; 58-65-1; 58-67-150; Eff. April 1, 1989; Amended Eff. April 8, 2002; Repealed Eff. November 1, 2021.

11 NCAC 04 .0120 POLICY OR SERVICE FEES An insurer, agent, broker, or limited representative who deals with an applicant and who intends to charge a policy or service fee in accordance with G.S. 58-33-85(b) shall not do so unless he or she complies with the following: (1) A sign …

11 NCAC 04 .0121 PREMIUM PAYMENT RECEIPTS All premium payment receipts and copies issued by an agent, broker, or limited representative, shall be dated and contain the printed or stamped name and address of the agency or agent, broker, or limited representative, and the name of t…

11 NCAC 04 .0122 POWER-OF-ATTORNEY Except for authorizations given in accordance with G.S. 58-45-35(a) or G.S. 58-46-15, no agent, broker, or limited representative shall solicit a power-of-attorney from a consumer that authorizes the agent, broker, or limited representative to s…

11 NCAC 04 .0123 USE OF SPECIFIC COMPANY NAME IN RESPONSES When an insurer makes a written response to an inquiry by the Division or complaint made by a consumer, the insurer shall identify on its response: (1) its mailing address; (2) official corporate name of the company again…

11 NCAC 04 .0124 INSURANCE COMPANY CONTACT PERSONS (a) Every insurer shall provide the Division with company contact information using a form provided by the Division, which shall include the name, title, address, and telephone number, including a toll-free number, of a designate…

11 NCAC 04 .0205 FUNCTION OF SECTION History Note: Authority G.S. 57-10; 57A-18; 58-7.3; 58-9; 58-9.2; 58-16; 58-25; 58-25.1; 58-26; 58-27; 58-296; Eff. December 15, 1979; Transferred to T11.11G; Eff. August 14, 1986.

11 NCAC 04 .0206 REPORT AND COLLECTION PROCEDURES History Note: Authority G.S. 57-10; 58-16; 58-16.2; 58-18; 58-63; Eff. December 15, 1979; Transferred to T11.11G; Eff. August 14, 1986.