may 2008 745-16
§ 745.201 Processing of Insurance Claims.
(a) Delegations of authority. The Agent for the
Liquidating Agent (‘‘Liquidating Agent’’) or his or her
designee is authorized to make initial determinations with respect to insurance
claims pursuant to the principles set forth in this Part, and to act on
requests for reconsideration of the initial determination.
(b) Initial determination. In the event the Liquidating
Agent determines that all or a portion of an accountholder’s account is
uninsured, the Liquidating Agent shall so notify the accountholder in writing,
stating the reason(s) for such initial determination, and shall provide the
accountholder with a certificate of claim in liquidation in the amount of the
uninsured account from the Board in its capacity as Liquidating Agent for the
insured credit union to enable the accountholder to share in the proceeds of
the liquidation of the credit union, if any, up to the amount of the uninsured
account.
(c) Request for Reconsideration. An accountholder may, at
his or her option, request reconsideration from the Liquidating Agent of the
initial determination within 30 days of the date of the initial determination,
or directly appeal the initial determination to the Board pursuant to §
745.202 of this subpart. The Liquidating Agent shall act on the request for
reconsideration within 30 days from its receipt.
§ 745.202 Appeal.
(a) Time for filing. Within 60 days after issuance of an
initial determination, or of the determination on a request for reconsideration
by the liquidating agent, the accountholder may appeal by filing with the Board
a written request for appeal. The appeal may be filed with the Secretary of the
Board, National Credit Union Administration, 1775 Duke Street, Alexandria, VA
22314–3428.
(b) Content of request. Any appeal must include:
(1) a statement of the facts on which the claim for
insurance is based;
(2) a statement of the basis for the initial
determination or determination on the request for reconsideration to which the
accountholder objects and the alleged error in such determination, including
citations to applicable statutes and regulations;
(3) any other evidence relied upon by the accountholder
which was not previously provided to the Liquidating Agent.
(c) Procedures for review of request.
(1) Within 60 days of the date of the Board’s
receipt of an appeal, the Board may request in writing that the accountholder
submit additional facts and records in support of its request. The
account-holder shall have 45 days from the date of issuance of such written
request to provide such additional information. Failure by the accountholder to
provide additional information may, as determined solely by the Board, result
in denial of the account-holder’s appeal.
(2) Within 60 days from the date of the Board’s
receipt of an appeal, the accountholder may amend or supplement the request in
writing. In the event that the accountholder does amend or supplement the
request, the provisions of paragraph (c)(1) of this section with respect to
requests for additional information and responses to such requests shall apply
with equal force to any such amendment or supplement to a request.
(d) Determination on appeal.
(1) Within 180 days from the date of the receipt of an
appeal by the Board, the Board shall issue a decision determining the extent of
the accountholder’s insurance pursuant to the rules of this Part.
(2) The determination by the Board on appeal shall be
provided to the accountholder in writing, stating the reason(s) for the
determination, and shall constitute a final Agency order regarding the
accountholder’s claim for insurance.
(3) If the Board determines that the account-holder is
entitled to the amount of insurance claimed or portion thereof, upon payment of
such insurance the accountholder shall promptly surrender to the Board the
certificate of claim in liquidation provided in connection with the initial
determination. In the event that the Board determines that the accountholder is
only entitled to a portion of the amount of insurance claimed, upon the
accountholder’s surrender of such certificate a new certificate of claim
in liquidation will be provided which reflects the revised amount of the
uninsured account.
PART 745 SHARE INSURANCE AND APPENDIX § 745.203
(4) Failure by the Board to issue a determination on
appeal of the accountholder’s claim for insurance within the 180-day
period provided for under this paragraph
(d)(1) shall be deemed to be a denial of such claim for
purposes of Section 745.203 of this subpart.
§ 745.203 Judicial Review.
(a) For purposes of seeking judicial review of actions
taken pursuant to this subpart, only a determination on appeal issued by the
Board pursuant to Section 745.202 of this subpart shall constitute a final
determination regarding an accountholder’s claim for insurance.
(b) Failure to file an appeal with regard to an initial
determination, or a decision rendered on a request for reconsideration within
the applicable time periods shall constitute a failure by the accountholder to
exhaust available administrative remedies and, due to such failure, any
objections to the initial determination or request for reconsideration shall be
deemed to be waived and such determination shall be deemed to have been
accepted by, and binding upon, the accountholder.
(c) Final determination by the Board is reviewable in
accordance with the provisions of Chapter 7, Title 5, United States Code, by
the United States Court of Appeals for the District of Columbia or the court of
appeals for the Federal judicial circuit where the credit union’s
principal place of business is located. Such action must be filed not later
than 60 days after such final determination is ordered.
793-1 may 2008 Part 793
Tort Claims Against the Government
§ 793.1 Scope of regulations.
The regulations in this Part shall apply only to claims
asserted under the Federal Tort Claims Act, as amended, 28 U.S.C. Sections
2671–2680, accruing on or after January 18, 1967, for money damages
against the United States for damage to or loss of property or personal injury
or death caused by the negligent or wrongful act or omission of any employee of
the National Credit Union Administration while acting within the scope of his
office of employment.
Subpart B—Procedures
§ 793.2 Administrative claim; when presented; place
of filing.
(a) For purposes of the regulations in this Part, a claim
shall be deemed to have been presented when the National Credit Union
Administration receives, at a place designated in paragraph (c) of this
Section, an executed Standard Form 95 or other written notification of an
incident accompanied by a claim for money damages in a sum certain for damage
to or loss of property, for personal injury, or for death, alleged to have
occurred by reason of the incident. A claim which should have been presented to
the National Credit Union Administration but which was mistakenly addressed to
or filed with another Federal agency, shall be deemed to be presented to the
National Credit Union Administration as of the date that the claim is received
by the National Credit Union Administration. A claim mistakenly addressed to or
filed with the National Credit Union Administration shall forthwith be
transferred to the appropriate Federal agency, if ascertainable, or returned to
the claimant.
(b) A claim presented in compliance with paragraph
(a) of this Section may be amended by the claimant at any
time prior to final action by the Office of General Counsel, National Credit
Union Administration or prior to the exercise of the claimant’s option to
bring suit under 28 U.S.C. 2675(a). Amendments shall be submitted in writing
and signed by the claimant or his duly authorized agent or legal
representative. Upon the timely filing of an amendment to a pending claim, the
National Credit Union Administration shall have 6 months in which to make a
final disposition of the claim as amended and the claimant’s option under
28 U.S.C. 2675(a) shall not accrue until 6 months after the filing of an
amendment.
(c) Forms may be obtained and claims may be filed with
the regional office of the National Credit Union Administration having
jurisdiction over the employee involved in the accident or incident, or with
the Office of General Counsel, National Credit Union Administration, 1775 Duke
Street, Alexandria, VA 22314–3428.
§ 793.3 Administrative claim; who may file.
(a) A claim for injury to or loss of property may be
presented by the owner of the property interest which is the subject matter of
the claim, his duly authorized agent, or his legal representative.
(b) A claim for personal injury may be presented by the
injured person, his duly authorized agent, or his legal representative.
(c) A claim based on death may be presented by the
executor or administrator of the decedent’s estate or by any other person
legally entitled to assert such a claim under applicable state law.
(d) A claim for loss wholly compensated by an insurer
with the rights of a subrogee may be presented by the insurer. A claim for loss
partially compensated by an insurer with the rights of a subrogee may be
presented by the insurer or the insured individually, as their respective
interests appear, or jointly. Whenever an insurer presents a claim asserting
the rights of a subrogee, he shall present with his claim appropriate evidence
that he has the rights of a subrogee.
(e) A claim presented by an agent or legal representative
shall be presented in the name of the claimant, be signed by the agent or legal
representative, show the title or legal capacity of the person signing, and be
accompanied by evidence of his authority to present a claim on behalf of the
claimant as agent, executor, administrator, parent, guardian, or other
representative.
§ 793.4 Administrative claim; evidence and
information to be submitted.
PART 793 NCUA RULES AND REGULATIONS § 793.5 may 2008
793-2
(a) Death. In support of a claim based on death, the
claimant may be required to submit the following evidence or information:
(1) An authenticated death certificate or other competent
evidence showing the cause of death, date of death, and age of the decedent.
(2) Decedent’s employment or occupation at the time
of death, including his monthly or yearly salary or earnings (if any), and the
duration of his last employment or occupation.
(3) Full names, addresses, birthdates, kinship, and
marital status of the decedent’s survivors, including those survivors who
were dependent for support upon the decedent at the time of his death.
(4) Degree of support afforded by the decedent to each
survivor dependent upon him for support at the time of his death.
(5) Decedent’s general physical and mental condition
before death.
(6) Itemized bills for medical and burial expenses
incurred by reason of the incident causing death, or itemized receipts of
payments for such expenses.
(7) If damages for pain and suffering before death are
claimed, a physician’s detailed statement specifying the injuries
suffered, duration of pain and suffering, any drugs administered for pain and
the decedent’s physical condition in the interval between injury and
death.
(8) Any other evidence or information which may have a
bearing on the responsibility of the United States for the death or the damages
claimed.
(b) Personal injury. In support of a claim based on
personal injury, the claimant may be required to submit the following evidence
or information:
(1) A written report by his attending physician or
dentist setting forth the nature and extent of the injury, nature and extent of
the treatment, any degree of temporary or permanent disability, the prognosis,
period of hospitalization, and any diminished earning capacity. In addition,
the claimant may be required to submit to a physical and/or mental examination
by a physician employed or designated by the National Credit Union
Administration. A copy or report of the examining physician shall be made
available to the claimant upon the claimant’s written request provided
that claimant has, upon request, furnished the report referred to in the first
sentence of this subparagraph and has made or agrees to make available to the
National Credit Union Administration any other physician’s reports
previously or thereafter made of the physical or mental condition which is the
subject of his claim.
(2) Itemized bills for medical, dental, and hospital
expenses incurred, or itemized receipts of payment for such expenses.
(3) If the prognosis reveals the necessity for future
treatment, a statement of expected duration of and expenses for such treatment.
(4) If a claim is made for loss of time from employment,
a written statement from his employer showing actual time lost from his
employment, whether he is a full or part time employee, and wages or salary
actually lost.
(5) If a claim is made for loss of income and the
claimant is self-employed, documentary evidence showing the amount of earnings
actually lost.
(6) Any other evidence or information which may have a
bearing on the responsibility of the United States for the personal injury or
the damages claimed.
(c) Property damage. In support of a claim for damages to
or loss of property, real or personal, the claimant may be required to submit
the following information or evidence:
(1) Proof of ownership.
(2) A detailed statement of the amount claimed with
respect to each item of property.
(3) An itemized receipt of payment for necessary repairs
or itemized written estimates of the cost of such repairs.
(4) A statement listing date of purchase, purchase price,
market value of the property as of date of damage, and salvage value, where
repair is not economical.
(5) Any other evidence or information which may have a
bearing on the responsibility of the United States for the injury to or loss of
property or the damages claimed.
(d) Time limit. All evidence required to be submitted by
this Section shall be furnished by the claimant within a reasonable time.
Failure of a claimant to furnish evidence necessary for a determination of his
claim within 3 months after a request therefor has been mailed to his last
known address may be deemed an abandonment of the claim. The claim may be
thereupon disallowed.
§ 793.5 Investigation, examination, and
determination of claims. When a claim is received, the constituent agency out
of whose activities the claim arose shall make such investigation as may be
necessary or appropriate for a determination of the validity of the claim and
thereafter shall forward the claim, together with all pertinent material, and a
recommendation based on the merits of the case, with regard to the allowance or
disallowance of the claim, to the Office of General Counsel, National Credit
Union Administration to whom authority has been delegated to adjust, determine,
compromise and settle all claims hereunder.
§ 793.6 Final denial of claim.
(a) Final denial of an administrative claim shall be in
writing and sent to the claimant, his attorney, or legal PART 793 TORT CLAIMS
AGAINST THE GOVERNMENT § 793.7 representative by certified or registered
mail. The notification of final denial may include a statement of the reasons
for the denial and shall include a statement that, if the claimant is
dissatisfied with the action of the National Credit Union Administration, he
may file suit in an appropriate U.S. District Court not later than 6 months
after the date of mailing the notification.
(b) Prior to the commencement of suit and prior to the
expiration of the 6-month period after the date of mailing, by certified or
registered mail of notice of final denial of the claim as provided in 28 U.S.C.
2401(b), a claimant, his duly authorized agent, or legal representative, may
file a written request with the National Credit Union Administration for
reconsideration of a final denial of a claim under paragraph (a) of this
Section. Upon the timely filing of a request for reconsideration the National
Credit Union Administration shall have 6 months from the date of filing in
which to make a final disposition of the claim and the claimant’s option
under 28 U.S.C. 2675(a) to bring suit shall not accrue until 6 months after the
filing of a request for reconsideration. Final National Credit Union
Administration action on a request for reconsideration shall be effected in
accordance with the provisions of paragraph (a) of this Section.
§ 793.7 Payment of approved claims.
(a) Upon allowance of his claim, claimant or his duly
authorized agent shall sign the voucher for payment, Standard Form 1145, before
payment is made.
(b) When the claimant is represented by an attorney, the
voucher for payment (S.F. 1145) shall designate both the claimant and his
attorney as ‘‘payees.’’ The check shall be delivered to the
attorney whose address shall appear on the voucher.
§ 793.8 Release.
Acceptance by the claimant, his agent or legal
representative, of any award, compromise or settlement made hereunder, shall be
final and conclusive on the claimant, his agent or legal representative and any
other person on whose behalf or for whose benefit the claim has been presented,
and shall constitute a complete release of any claim against the United States
and any employee of the Government whose act or omission gave rise to the
claim, by reason of the same subject matter.
§ 793.9 Penalties. A person who files a false claim
or makes a false or fraudulent statement in a claim against the United States
may be liable to a fine of not more than $10,000 or to imprisonment of not more
than 5 years, or both (18 U.S.C. 287–1001), and, in addition, to a
forfeiture of $2,000 and a penalty of double the loss or damage sustained by
the United States (31 U.S.C. 231).
§ 793.10 Limitation on National Credit Union
Administration’s authority.
(a) An award, compromise or settlement of a claim
hereunder in excess of $25,000 shall be effected only with the prior written
approval of the Attorney General or his designee. For purposes of this
paragraph, a principal claim and any derivative or subrogated claim shall be
treated as a single claim.
(b) An administrative claim may be adjusted, determined,
compromised or settled hereunder only after consultation with the Department of
Justice when, in the opinion of the National Credit Union Administration:
(1) A new precedent or a new point of law is involved; or
(2) A question of policy is or may be involved; or
(3) The United States is or may be entitled to indemnity
or contribution from a third party and the National Credit Union Administration
is unable to adjust the third party claim; or
(4) The compromise of a particular claim, as a practical
matter, will or may control the disposition of a related claim in which the
amount to be paid may exceed $25,000.
(c) An administrative claim may be adjusted, determined,
compromised or settled only after consultation with the Department of Justice
when it is learned that the United States or any employee, agent or cost-plus
contractor of the United States is involved in litigation based on a claim
arising out of the same incident or transaction. |
