(1) (a) Unless otherwise provided by law, an insurer shall timely pay every valid insurance claim made by an insured. (b) By rule the commissioner may prescribe: (i) the kinds of notice and proof of loss that will establish validity; (ii) the manner in which an insurer may make a bona fide denial of a claim; (iii) the periods of time within which payment is required to be made to be timely; and (iv) the reasonable interest rates to be charged upon late claim payments.
(a) Unless otherwise provided by law, an insurer shall timely pay every valid insurance claim made by an insured.
(b) By rule the commissioner may prescribe: (i) the kinds of notice and proof of loss that will establish validity; (ii) the manner in which an insurer may make a bona fide denial of a claim; (iii) the periods of time within which payment is required to be made to be timely; and (iv) the reasonable interest rates to be charged upon late claim payments.
(i) the kinds of notice and proof of loss that will establish validity;
(ii) the manner in which an insurer may make a bona fide denial of a claim;
(iii) the periods of time within which payment is required to be made to be timely; and
(iv) the reasonable interest rates to be charged upon late claim payments.
(2) (a) Notwithstanding Subsection (1) and subject to Subsection (2)(b), the payment of a claim is not overdue during any period in which: (i) the insurer is unable to pay the claim because there is no recipient legally able to give a valid release for the payment; or (ii) the insurer is unable to determine who is entitled to receive the payment. (b) Subsection (2)(a) applies only if the insurer: (i) promptly notifies the claimant of the inability to pay the claim; and (ii) offers in good faith to pay the claim promptly when the inability to pay the claim is removed.
(a) Notwithstanding Subsection (1) and subject to Subsection (2)(b), the payment of a claim is not overdue during any period in which: (i) the insurer is unable to pay the claim because there is no recipient legally able to give a valid release for the payment; or (ii) the insurer is unable to determine who is entitled to receive the payment.
(i) the insurer is unable to pay the claim because there is no recipient legally able to give a valid release for the payment; or
(ii) the insurer is unable to determine who is entitled to receive the payment.
(b) Subsection (2)(a) applies only if the insurer: (i) promptly notifies the claimant of the inability to pay the claim; and (ii) offers in good faith to pay the claim promptly when the inability to pay the claim is removed.
(i) promptly notifies the claimant of the inability to pay the claim; and
(ii) offers in good faith to pay the claim promptly when the inability to pay the claim is removed.
(3) This section applies only to a claim for first party benefits made by a person who is: (a) named or defined as an insured under the terms of an insurance policy; (b) described as a covered person under the terms of a policy of health care insurance as defined in Section 31A-1-301; or (c) named, defined, or described: (i) as: (A) an insured; (B) a beneficiary; (C) a policyholder; or (D) otherwise covered person; and (ii) under the terms of: (A) a life insurance policy; or (B) an annuity.
(a) named or defined as an insured under the terms of an insurance policy;
(b) described as a covered person under the terms of a policy of health care insurance as defined in Section 31A-1-301; or
(c) named, defined, or described: (i) as: (A) an insured; (B) a beneficiary; (C) a policyholder; or (D) otherwise covered person; and (ii) under the terms of: (A) a life insurance policy; or (B) an annuity.
(i) as: (A) an insured; (B) a beneficiary; (C) a policyholder; or (D) otherwise covered person; and
(A) an insured;
(B) a beneficiary;
(C) a policyholder; or
(D) otherwise covered person; and
(ii) under the terms of: (A) a life insurance policy; or (B) an annuity.
(A) a life insurance policy; or
(B) an annuity.
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.