Scope and Definitions

PURPOSE: This rule sets out the scope of the rules in this chapter and provides definitions to aid in the interpretation of the rules in this chapter. (1) Applicability of Rules. The rules in this chapter apply to all hearings conducted pursuant to the enforcement procedures in sections 374.046 through 384.049, RSMo and other contested cases arising from provisions in Chapters 354 and 374 through 385, RSMo, unless the rules conflict with specific statutory hearing requirements, in which case the statutory requirements shall prevail. The rules shall be read together with Chapter 536, RSMo. (2) Definitions. (A) “Certificate of Authority,” the whole or part of any certificate of approval or charter granted by the director for any insurance company, insurer, association, health services corporation, health maintenance organization, or other legal entity insuring risk. (B) “Director,” the director of the department. (C) “Department,” the Department of Commerce and Insurance. (D) “License,” the whole or part of any permit, registration, membership, statutory exemption or any other form of permission granted by the director to any person. (E) “Party,” any individual, partnership, corporation, association, public or private organization of any character or any other governmental agency properly requesting a hearing, named as a respondent, seeking to be heard or entitled to intervene in any matter under the rules in this chapter. (F) “Respondent,” a party in an administrative proceeding before the director and against whom administrative relief is sought under section 374.046 or 374.047, RSMo or other provisions in Chapters 354 or 374 through 385, RSMo. AUTHORITY: sections 354.120 and 374.045, RSMo 2000 and sections 374.705, 376.1528, and 385.218, RSMo Supp. 2007.* Original rule filed Sept. 5, 2007, effective May 30, 2008. Non-substantive change filed Sept. 11, 2019, published Oct. 31, 2019. *Original authority: 354.120, RSMo 1973, amended 1983, 1993, 1995; 374.045, RSMo 1967, amended 1993, 1995; 374.705, RSMo 1983, amended 1993, 2004; 376.1528, RSMo 2007; and 385.218, RSMo 2007.