Ga. Comp. R. & Regs. R. 120-2-46-.03 - Application for Self-Insurance
(1) An application for self-insurance shall
be made on an approved form to the Commissioner of Insurance. The application
shall contain:
(a) A list of all vehicles
registered in the name of the applicant including the make, model, year,
manufacturer's identification number, title certificate number or other proof
of ownership, and license plate number (if issued). Lists compiled by magnetic
tape, floppy disk, or by other electronic data systems shall be permitted if
acceptable to the Commissioner;
(b)
A complete audited financial statement of assets, liabilities, including the
projected impact of open and pending claims, and net worth for the latest
financial year of the applicant in sufficient detail to show that the applicant
possesses and will continue to possess the ability to pay judgments or valid
claims. All audited financial statements shall be prepared by and certified as
to the correctness by an independent certified public accountant; and
(c) A blank copy of the self-insurance
identification card to be utilized by the applicant as provided in paragraph
(2) of this Rule.
(2)
Each applicant shall furnish an agreement to:
(a) Provide efficient claims handling
procedures substantially equivalent to those afforded by a policy of automobile
liability insurance in compliance with O.C.G.A. Chapter 33-34, the "Georgia
Motor Vehicle Accident Reparations Act." The applicant shall attach a complete
copy of the procedures which the applicant will use in investigating and
adjusting claims, including amounts of coverages, benefits, and payment
procedures;
(b) Provide the
coverages and benefits required under O.C.G.A. Chapter 33-34, the "Georgia
Motor Vehicle Reparations Act," and O.C.G.A. Chapter 40-9, the "Motor Vehicle
Safety Responsibility Act," except that uninsured motorist coverages as
provided in O.C.G.A. Section
33-7-11 and optional personal
injury protection coverages as provided in O.C.G.A. Section
33-34-5 shall not be
required;
(c) Issue a
self-insurance identification card for each vehicle to be carried in each
vehicle, showing:
1. The self-insurer's
certificate number, issue date, expiration date, vehicle, year, make, model,
and vehicle identification number; or
2. The self-insurer's certificate number,
issue date, and expiration date, with an individual number assigned to each
such card. The cards permitted under this subparagraph shall be serialized and
an inventory kept of the number of such cards issued and the vehicle to which
each numbered card is assigned; and
(d) Allow the Commissioner of Insurance or
his representative to examine and verify at any time pertinent information
contained in the application for self-insurance or any financial statement.
Examinations may consist of, but are not limited to, on-site inspection of
vehicles, premises, claims files and accounting records. Costs associated with
any examination as ordered by the Commissioner shall be borne by the
self-insurer.
(3)
Information listing accidents in which applicants' vehicles were involved
during the preceding three years shall be furnished, subject to requests for
further information by the Commissioner.
Notes
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