Maine P&C Study Guide

On the regulatory half of Maine’s law, read the unit as carefully as the number. The guaranty statute carries four dollar figures measured four different ways, and the producer-conduct rules put a hard deadline on one side of a transaction and none on the other.

Four guaranty numbers, four units of measurement

The money sits in 24-A M.R.S. §4438, which changes units as it goes.

• Most covered claims — “an amount not exceeding $300,000 per claim,” for everything other than workers’ compensation.
• Workers’ compensation — uncapped: “the full amount of a covered claim for benefits, including interest and all penalties payable to a claimant …”
• Unearned premium — “an amount not exceeding $25,000 per policy,” and only amounts exceeding $50 are paid. A fifty-dollar floor under the ceiling.
• Cybersecurity — “an amount not exceeding $500,000 for covered claims arising out of a single insured event under a policy or endorsement of cybersecurity insurance.”

Per claim. In full. Per policy. Per event. The tempting wrong answer is rarely a wrong figure — it is the right figure attached to the wrong unit.

The exclusions are in the definition, not with the money

Asked where the high-net-worth exclusion lives, most candidates pick the section with the dollar caps. Wrong section: the work is done by the definition of “covered claim” at §4435(4), which excludes punitive damages, requires a policy “issued by an insurer that becomes an insolvent insurer after May 9, 1970” — the clock runs on the insolvency, not on the policy’s issue date — and excludes a first-party claim by an insured whose net worth exceeds $25,000,000 as of 31 December of the year before the insolvency. Claims must be filed within 24 months after the order of liquidation. Four limits, none of them where you would look for them.

Maine has a Superintendent, not a Commissioner

§201 puts a Superintendent of Insurance at the head of the Bureau of Insurance, inside the Department of Professional and Financial Regulation. Not a Commissioner, and not an elected office — appointed by the Governor, subject to legislative review and confirmation, for a five-year term. Free marks — and the Maine numbers most likely to be misremembered.

Rebating: both sides of the transaction

§2160 (life, health, annuity) and §2162 (property, casualty, surety) prohibit giving a rebate. Then the twist most candidates miss: §2163 makes receiving one unlawful too. The insured who accepts a rebate has broken the statute alongside the producer who offered it.

§2163-A is the safe harbour. Gifts of “not more than $100 per year per person.” Raffle prizes “not valued in excess of $500.” And neither may be cash.

Somebody else’s money

§1449: “All premiums and return premiums received by an insurance producer are trust funds received by the licensee in a fiduciary capacity.”

Then the asymmetry. Return premiums go to the insured, or against outstanding balances, within 30 days of receipt. Premiums owed to the insurer carry no day count at all — they are paid “promptly … in accordance with the contract.” The clock runs toward the consumer; the contract runs toward the carrier.

Underneath sits Rule ch. 540, and its anti-commingling rule is absolute. A producer keeps “one or more separate premium trust accounts,” and “under no circumstances shall an insurance producer place fiduciary funds in a personal or business operating account.” The account and its cheques must carry the words “premium trust account,” and no de minimis threshold appears anywhere in the rule.

Two unfair-claims statutes doing opposite jobs

They look like one subject and they are not. §2164-D is the Superintendent’s tool, and it creates no private cause of action. Its only hard day count is failing to provide claim forms within 15 calendar days of request.

§2436-A is the insured’s tool — a private action for damages, attorney’s fees, costs and “interest on damages at the rate of 1.5% per month.”

Notice how few fixed deadlines Maine writes into either — the duties run on “promptly” and “within a reasonable time,” and those fifteen days are the only number. Maine does not use the familiar 15/15/10 grid, which is where the familiar model timetable leads you astray.