Utah Admin. Code R37-1-5 - Coverage and Conditions

(1) Coverage - Specific risks covered, properties covered, coverage limits, exclusions, deductibles, conditions and other provisions for coverage through the Fund, or through any captive, shall apply in accordance with the terms of annual coverage agreements or policies issued or procured by the Fund, or in accordance with any policies issued by a captive.

(2) Conditions - The following conditions apply to each line of coverage provided by the Fund or any captive:

(a) In the event of an occurrence, loss, personal injury, act, error, omission, incident, or any other situation likely to give rise to a claim covered by the Fund or any captive, each covered entity shall immediately provide written notice to the Fund or captive.

(i) Written notice shall include:

(A) particulars sufficient to identify the covered entity or covered persons;

(B) reasonably obtainable information with respect to the time, place and circumstances thereof; and

(C) the names and addresses of potential claimants and all known witnesses.

(ii) The covered entity shall promptly take all reasonable steps to prevent additional injury or damage arising out of the same or similar conditions.

(iii) A covered entity's failure to take preventive measures shall not constitute a breach of this condition unless the Fund has requested the covered entity, in writing, to undertake the preventive measures.

(iv) Costs incurred by a covered entity to implement preventive measures shall not be recoverable from the Fund or any captive.

(b)

(i) If claim is made or suit is brought against the covered entity or person, whether in court or through an administrative proceeding with the Utah Anti-discrimination Division, the Federal Equal Employment Opportunity Commission or similar body, the covered entity or person shall immediately forward to the Fund or captive a copy of each demand, notice, summons or other process received by it or its representative.

(ii) Any covered person who is an employee or volunteer of the covered entity shall comply with Sections 63G-7-902 and 63G-7-903 before the Fund or any captive shall have any duty to defend or pay any judgment against such covered person.

(c) The covered entity or person shall:

(i) cooperate with the Fund or captive; and (ii) upon the Fund or captive's request;

(A) provide the Fund or captive with requested information;

(B) assist in making settlements;

(C) assist in making rule 68 settlement offers of judgment per Utah Rules of Civil Procedure;

(D) assist in the conduct of suits;

(E) assist in enforcing any right of contribution or indemnity against any person or organization who may be liable to the covered entity or person because of bodily injury or property damage with respect to which coverage is afforded by the Fund or captive;

(F) attend hearings and trials; and

(G) assist in securing and providing evidence and obtaining the attendance of witnesses.

(d) The covered entity or person may not, except at its own cost:

(i) voluntarily make any payment;

(ii) assume any obligation; or

(iii) incur any expense other than for qualified first aid to others immediately following an injury or accident.

(e)

(i) In the event any employees or volunteers request under the terms of Section 63G-7-902 that the covered entity defend them relative to any action or claim which would be covered by the Fund or captive, the covered entity shall immediately forward the request to the Fund or captive, which shall have the right to determine on behalf of the covered entity whether to:

(A) defend;

(B) defend under a reservation of rights; or

(C) decline to defend.

(f) The covered entity or person shall share each record requested by the Fund or captive, relative to any claim under their coverage, to the fullest extent permitted by Title 63G, Chapter 2, Government Records Access and Management Act.

(3) Coverage Disputes and Subrogation -- The following conditions are applicable to all lines of coverage provided by the Fund and any captive:

(a) In the event of any coverage dispute between the Fund or any captive and any covered entity or person, there shall be no right of legal action against the Fund or any captive unless otherwise required by Title 31A, Chapter 37, Captive Insurance Companies Act.

(b) In the event of any payment under any coverage provided through the Fund or any captive:

(i) the Fund or captive shall be subrogated to all the covered entity or person's rights of recovery against any person or organization;

(ii) the covered entity or person shall execute and deliver instruments and papers and do whatever else is necessary to secure these rights; and

(iii) the covered entity or person may not prejudice these rights.

Notes

Utah Admin. Code R37-1-5

Amended by Utah State Bulletin Number 2023-05, effective 2/22/2023