Frequently Asked Questions
General

What is the South Carolina Property and Casualty Insurance Guaranty Association?

The South Carolina Property and Casualty Insurance Guaranty Association (SCPCIGA) is a nonprofit, unincorporated legal entity created in 1971 by the South Carolina Legislature (South Carolina Code of Laws: Title 38, Chapter 31). The SCPCIGA pays certain outstanding claims of insolvent insurance companies. The purpose of the Association is to provide a safety net for insurance consumers if their insurance company becomes insolvent and is no longer able to meet its obligations. All 50 states, Puerto Rico, the United States Virgin Islands (property/casualty only), and the District of Columbia have a guaranty mechanism in place for the payment of covered claims arising from the insolvency of insurers licensed in their state. State laws require that licensed property and casualty insurance companies belong to the guaranty associations in every state where they are licensed to do business. Funding for the guaranty associations comes from assessments on solvent insurers.

How do I contact the South Carolina Property and Casualty Insurance Guaranty Association?

We are located in Columbia, South Carolina. Please view our Contact Us page for updated contact information.

What types of insurance does the SCPCIGA cover?

We cover property and casualty lines of insurance, such as auto, homeowner's, worker's compensation, general liability and professional liability policies.

What isn't covered?

SCPCIGA does not cover life, annuity, health or disability insurance. Questions about those lines of insurance should be directed to the South Carolina Life and Accident and Health Insurance Guaranty Association.

SCPCIGA also does not cover mortgage guaranty, financial guaranty, or any type of protection against investment risks. Fidelity, surety, or other bonding obligations are not covered. Warranties or service contracts are also not covered. SCPCIGA does not cover retroactive insurance.

SCPCIGA does not cover title insurance or marine insurance. It does not cover contracts where there is no transfer of risk.

The insolvent insurer must be admitted and licensed by the South Carolina Department of Insurance.

Should I get a new insurance policy?

Yes. Most liquidation orders cancel all policies within a certain time after liquidation, typically 30 days. You will need to obtain coverage from another insurance company. However, we do not make recommendations. You may contact any licensed insurance agent to get the names of other insurers.

The South Carolina Department of Insurance has a Consumer Services Division which can assist you. You can reach them at (803) 737-6180 or consumers@doi.sc.gov.



Claims

Will someone from SCPCIGA contact me about my claim?

We will try to contact each person who had an open claim on file with the impaired insurer. As soon as possible after we receive the claim files from the company's receiver, we will mail out letters detailing your rights under the Guaranty Act and letting you know how to contact us. If you do not hear from us within a month from the date the company became impaired, feel free to contact us. However, we will be unable to give you specific information about your claim or to make any payments until we have received your claim file from the receiver.

Will there be delays in the handling of my claim?

Some delays are likely since we must first obtain the files from the insolvent insurer and have time to review them. Oftentimes, the files are disorganized or in poor condition when we receive them. We will make every effort to quickly identify and expedite the handling of any hardship cases, such as when your auto is in the repair shop and can't be released until your claim is paid. Be patient, and we will handle your claim as soon as practicable. We will make every effort to ensure that workers compensation periodic indemnity claims continue to be paid without interruption.

Are there limits on the amount that SCPCIGA will pay?

Yes. Covered claims are paid according to policy contract amounts and state-established limits. Subject to policy contract provisions, conditions, deductibles, and limits, as well as those stated in South Carolina Law, Title 38, Chapter 31, the following limits may apply:

  • Property Casualty Claim: Amount of each covered claim in excess of $250.00 and less than $300,000.00
  • Worker' Compensation Claim: Statutory benefits
  • Unearned Premium Claim: The association will pay only that amount which is in excess of $100.00
  • Note: A first party claim cannot be made against the Association by an insured whose net worth exceeds ten million dollars on December 31st of the year preceding the date of insurer's insolvency. A person having a net worth of greater than twenty-five million dollars and having a claim against an insolvent insurer under any provision in an insurance policy may not make a claim against the Association.

What requirements must be met for my claim to be covered by SCPCIGA?

To be covered, a number of conditions must be met. At a minimum, the claim must:

  1. Be unpaid- that is, the claim must not have been previously paid by the insurance carrier or other party.
  2. Exist before the insolvency or arise within 30 days after the Order of Liquidation- the claim must arise while the policy is still in force.
  3. Be on a policy written by an insolvent insurer that was licensed to do business in the state, and in a line of business covered by the guaranty association. Policies sold by companies that are not members of the guaranty association are not covered.
  4. Be brought by a claimant or insured who is a resident of the state. Only claims brought by residents or insureds of the state, or where the claim relates to property located in the state, are covered by the state guaranty fund.
  5. Be filed with the guaranty association before the claims cut-off date. South Carolina Law requires that a claim must be filed within 18 months of the liquidation or earlier if required by the liquidation order. Your claim must be filed before that date to be covered.
  6. Not be covered by other insurance if there is other insurance from which your claim can be paid. You must first exhaust that coverage before the guaranty fund will pay any portion of the claim.

How long will it take for SCPCIGA to pay my claim?

The amount of time it takes to pay a claim can vary widely depending upon a number of factors, but claim payments usually begin as soon as possible following the Order of Liquidation. A period of 60-90 days is not uncommon. Many insurance carriers have their claims processed by a Third-Party Administrator (TPA). If this is true with your claim, the amount of time needed to get all claim information might be extended as files are gathered from TPAs and transmitted to the guaranty associations.

I already filed my claim with my insurance company; do I have to file it again with SCPCIGA?

So long as your claim appears in the company's records, SCPCIGA will have notice of your claim and there is no need to file it again. However, if it has been more than a month since your insurer became impaired and you have not yet heard from SCPCIGA, you should contact us to be sure we have a record of your claim.

Is there a deadline to file a claim with SCPCIGA?

Yes. The deadline for filing claims is determined by the Order of Liquidation. This is typically twelve to eighteen months after the date that the receivership court enters an order of liquidation. If you had already filed a claim with the insurer prior to receivership, SCPCIGA considers your claim to have been filed prior to the deadline.

I received a Proof of Claim, what should I do?

Proofs of Claim are sent by the receiver or liquidator of the insolvent insurer; they are not sent by SCPCIGA. Contact the receiver or liquidator if you have questions about whether to file a Proof of Claim.

Do I have to file a Proof of Claim with the Liquidator?

It is not necessary to file a Proof of Claim to assert a claim against SCPCIGA. However, you must file a Proof of Claim to protect your rights to share in any distribution from the receivership estate, particularly for claims that are not covered by SCPCIGA or that exceed our "cap."

What do I do if I receive notice of a new claim against me or if I am served with a lawsuit?

You should immediately contact SCPCIGA and send a copy of the claim and/or lawsuit to our office by facsimile and by certified mail.

Will SCPCIGA take over the defense of my pending lawsuit?

If the lawsuit is within the coverage of the applicable policy, SCPCIGA will continue to defend the insured to the extent of coverage under the policy and the Guaranty Act. SCPCIGA may choose to retain the same attorney, or we may decide to have the case referred to a different attorney.

Will SCPCIGA report claim payments under the new Medicare reporting law?

In compliance with the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), SCPCIGA will perform the appropriate CMS queries and serve as the Responsible Reporting Entity for any claim payments it makes that are subject to the MMSEA.

Why is SCPCIGA asking for my social security number?

SCPCIGA uses social security numbers only for certain claims-related activities. Beginning in 2011, the federal Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) will require that we also determine whether a person receiving a payment for bodily injury is a Medicare beneficiary. To do so, we must obtain the claimant's social security number. For more information on MMSEA, go to https://www.cms.gov.



Unearned Premium

Does SCPCIGA refund premiums for the unexpired term of policies cancelled because of liquidation?

SCPCIGA will pay unearned premium claims for covered lines of business after the Receiver completes its processing of the policy records and sends the unearned premium records to SCPCIGA. Policyholders will be refunded only for the portion of unearned premium collected by the insolvent company. Additionally, SCPCIGA will pay only that amount which is in excess of $100.00 of the unearned premium claim.

Do policyholders need to file a claim with SCPCIGA to receive their unearned premium?

No, the Receiver deems claims for unearned premium as automatically filed so no action is required by the policyholder. SCPCIGA will process return premium payments after receiving policy information from the Receiver which they traditionally deliver after the policy cancellation date.

When can I expect SCPCIGA to pay my unearned premium claim?

SCPCIGA will pay unearned premium claims after the Receiver completes its processing of the policy records and sends the unearned premium record to SCPCIGA. This may take several weeks or several months depending on the condition of the data at the insolvent insurance company.



Workers' Compensation

Will there be an interruption in my workers' compensation benefits?

SCPCIGA makes every effort to ensure that the payment of weekly workers' compensation benefits continues without interruption. However, our efforts are subject to the availability of claim files and necessary information from the insolvent company, and it is possible that there may be an interruption in your weekly benefits. In addition, our review of the file may result in a change in the amount or availability of benefits.

May I continue to see the doctor treating me for my workers' compensation claim?

Yes. You should advise the doctor to contact SCPCIGA for authorization and billing information.

Doesn't HIPAA prevent me from disclosing worker's compensation patient information to SCPCIGA?

Employers, workers' compensation insurance carriers, physicians, and other participants in the workers' compensation system are permitted to share protected health information with each other in connection with workers' compensation claims and appeals.

 


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