LegalFix

§ 58-12-34 Acts constituting unfair claims practices.

SD Codified L § 58-12-34 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

58-12-34. Acts constituting unfair claims practices. Any of the following acts by an insurer, if committed in violation of § 58-12-33, is an unfair claims practice:

(1) Knowingly misrepresents to a claimant or an insured a relevant fact or policy provision relating to coverages at issue;

(2) Fails to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;

(3) Fails to adopt and implement reasonable standards to promptly complete claim investigations and settlement of claims arising under its policies;

(4) Fails to make a good faith attempt to effectuate prompt, fair, and equitable settlement of claims submitted in which liability coverage, and causation of claims have become reasonably clear;

(5) Compels an insured or beneficiary to institute a suit to recover an amount due under its policies by offering substantially less than the amount ultimately recovered in a suit brought by the insured or beneficiary;

(6) Refuses to pay claims without conducting a reasonable claim investigation;

(7) Fails to affirm or deny coverage of claims within a reasonable time after having completed a claim investigation related to the claim;

(8) Attempts to settle a claim for less than the amount that a reasonable person would believe the insured or beneficiary is entitled by reference to written or printed advertising material accompanying or made part of an application;

(9) Attempts to settle a claim on the basis of an application that was materially altered without notice to, or knowledge or consent of, the insured;

(10) Makes a claim payment to an insured or beneficiary without indicating the coverage under which each payment is being made;

(11) Unreasonably delays a claim investigation or payment of a claim by requiring both a formal proof of loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form;

(12) Fails, in the case of a claim denial or offer of compromise settlement, to promptly provide a reasonable and accurate explanation of the basis for such action; or

(13) Fails to provide forms necessary to present a claim within fifteen days of a request with reasonable explanations regarding their use.Source: SL 2014, ch 235, § 4.

LegalFix

Copyright ©2024 LegalFix. All rights reserved. LegalFix is not a law firm, is not licensed to practice law, and does not provide legal advice, services, or representation. The information on this website is an overview of the legal plans you can purchase—or that may be provided by your employer as an employee benefit or by your credit union or other membership group as a membership benefit.

LegalFix provides its members with easy access to affordable legal services through a network of independent law firms. LegalFix, its corporate entity, and its officers, directors, employees, agents, and contractors do not provide legal advice, services, or representation—directly or indirectly.

The articles and information on the site are not legal advice and should not be relied upon—they are for information purposes only. You should become a LegalFix member to get legal services from one of our network law firms.

You should not disclose confidential or potentially incriminating information to LegalFix—you should only communicate such information to your network law firm.

The benefits and legal services described in the LegalFix legal plans are not always available in all states or with all plans. See the legal plan Benefit Overview and the more comprehensive legal plan contract during checkout for coverage details in your state.

Use of this website, the purchase of legal plans, and access to the LegalFix networks of law firms are subject to the LegalFix Terms of Service and Privacy Policy.

We have updated our Terms of Service, Privacy Policy, and Disclosures. By continuing to browse this site, you agree to our Terms of Service, Privacy Policy, and Disclosures.
§ 58-12-34 Acts constituting unfair claims practices.