Ohio Property and Liability Insurance Guaranty Association (OPLIGA)

The Ohio Property and Liability Insurance Guaranty Association (OPLIGA) protects Ohio residents when P&C insurance companies become insolvent.

Purpose and Function

OPLIGA:

• Protects policyholders of insolvent P&C insurers
• Pays covered claims up to statutory limits
• Funded by assessments on member insurers
• Operates under state law supervision

How It Works

When a P&C insurer becomes insolvent:

1. ODI takes action - Places insurer in liquidation
2. OPLIGA activates - Takes responsibility for covered claims
3. Claims processed - OPLIGA pays covered claims
4. Assessments made - Member insurers pay assessments

Coverage Limits

OPLIGA provides coverage up to specific limits:

Claim Limits

Important Limitations

• $300,000 maximum per claim (not per policy)
• No coverage for first $100 of each claim (deductible)
• Net worth reduction may apply for large insureds
• Claims must have arisen before insolvency order

What Is Covered

OPLIGA covers claims under:

Covered Policies

• Homeowners insurance
• Auto insurance
• Commercial property
• Commercial liability
• Medical malpractice (with limits)

What's NOT Covered

Workers' Compensation Note

Workers' compensation in Ohio is through the BWC state monopoly fund, not private insurers. Therefore:

• OPLIGA does not cover workers' comp claims
• BWC has its own protections
• Self-insured employers have separate guaranty fund

Funding

OPLIGA is funded by assessments on member insurers:

Assessment Process

• Member insurers pay assessments when needed
• Based on premium volume in Ohio
• May be recouped through rate increases
• Separate accounts by line of insurance

Assessment Accounts

Producer Restrictions

Advertising Prohibition

Producers cannot:

• Use OPLIGA coverage as a selling point
• Advertise guaranty association protection
• Imply policies are "guaranteed" by OPLIGA
• Compare OPLIGA to FDIC
• Suggest choosing insurer based on OPLIGA

Required Conduct

• Provide accurate information if asked directly
• Cannot misrepresent coverage limits
• Cannot suggest coverage exceeds actual limits
• Must not use to induce sales

Exam Tip: Remember that producers CANNOT use OPLIGA coverage as a selling point. This is a frequently tested rule in Ohio.

Claims Process

When an insurer becomes insolvent:

1. Notice sent - OPLIGA notifies policyholders
2. Claims submitted - Directly to OPLIGA
3. Claims evaluated - Within statutory limits
4. Benefits paid - If claim is covered
5. Policy may end - Policyholder finds new coverage

Filing Deadline

• Claims must be filed with OPLIGA by deadline set in insolvency order
• Typically have limited time after insolvency
• Late claims may be denied