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31.15.07.00.htm 31.15.07.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 15 UNFAIR TRADE PRACTICES Chapter 07 Payment of Claims Under Property and Casualty and Title Insurance Policies Authority: Insurance Article, §1-301, 2-109, 2-205, 2-207, 4-113, 10-126, 10-410, 19-505, 19-506, 19-508, and 27-301―27-306, Annotated Code of Maryland
31.15.07.01.htm 31.15.07.01. 01 Scope.. This chapter is applicable to all property and casualty and title insurers, but does not include reinsurance, workers' compensation, or surety.
31.15.07.02.htm 31.15.07.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Application" means an initial application for the issuance of an insurance policy.. 2) "Claim" means a demand for payment or an inquiry regarding the possibility of payment for a loss incurred under one or more coverages provided by the policy.3) "Claimant" means either a first-party claimant or a third-party claimant and may include, in a particular case, the claima
31.15.07.03.htm 31.15.07.03. 03 Unfair Claim Settlement Practices.. A. A prohibited unfair claim settlement practice occurs if an insurer commits one or more of the following acts:1) Misrepresents pertinent facts or policy provisions relating to the claim at issue. For the purposes of this regulation, misrepresentation includes, but is not limited to, the following acts:a) Providing incomplete or misleading disclosure of pertinent facts or policy provisions relating to the claim at issue;
31.15.07.04.htm 31.15.07.04. 04 Standards for Prompt Investigation of Claims.. A. Insurers shall, for at least 3 years, make available for inspection by the Maryland Insurance Administration records of denials of claims and supporting documentation.B. If an insurer has not completed its investigation of a first party claim within 45 days of notification, the insurer shall promptly notify the first-party claimant, in writing, of the actual reason that additional time is necessary to complete the
31.15.07.05.htm 31.15.07.05. 05 Time for Filing Claim for Personal Injury Protection Benefits.. Upon receipt of written notice from an insured of the occurrence of an accident, each insurer providing benefits required under Insurance Article, §19-505, Annotated Code of Maryland, shall notify the insured of the latest date on which an original claim for benefits may be presented to the insurer, as provided in Insurance Article, §19-508(a) Annotated Code of Maryland.
31.15.07.06.htm 31.15.07.06. 06 Payment of Interest on Personal Injury Protection Benefits.. Whenever a claim for benefits under Insurance Article, §19-505, Annotated Code of Maryland, is paid more than 30 days after receipt of a properly completed claim form or other proof of loss and satisfactory proof verifying the claim, the insurer shall:A. Make a notation in the insurer's claim file stating the reason for the delay; and. B. Add to the amount otherwise payable 1-1/2 percent simple interest per mo
31.15.07.07.htm 31.15.07.07. 07 Computation of Time.. If an insurer requires additional information in order to properly consider a claim, the number of days which elapse between the date the insurer requests additional information and the date the insurer receives a response to the request may not be counted whenever these regulations require action by an insurer within a stated period of time.
31.15.07.08.htm 31.15.07.08. 08 Claims Registers.. A. Each insurer shall maintain claims registers separately for:. 1) Private passenger automobile insurance;. 2) All other liability insurance;. 3) Homeowner's insurance;. 4) All other property insurance; and. 5) Title insurance.. B. Claims registers may be maintained manually or on computer-generated tapes from which hard copy can be supplied.C. Claims registers shall list chronologically, by date of report, each claim received, if a Marylan
31.15.07.09.htm 31.15.07.09. 09 General Business Practices.. A. The methodology of §B of this regulation shall be used to determine whether an insurer has engaged in unfair claim settlement practices with such frequency as to constitute a general business practice within the meaning of Insurance Article, §27-304, Annotated Code of Maryland.B. It shall be considered prima facie evidence of a general business practice of committing unfair claim settlement practices if, in any 12-month peri
31.15.07.10.htm 31.15.07.10. 10 Penalties.. Penalties for violations of these regulations shall be assessed in accordance with Insurance Article, §4-113, 27-301, 27-305, and 27-306, Annotated Code of Maryland.
31.15.07.9999.htm 31.15.07.9999. Administrative History Effective date: July 23, 1990 (17:14 Md. R. 1758). Regulation .04G adopted effective April 1, 1991 (18:6 Md. R. 685). Regulation .04G repealed as an emergency provision effective April 6, 1991 (18:9 Md. R. 1004) emergency status expired August 6, 1991; repealed permanently effective August 19, 1991 (18:16 Md. R. 1811) ―Chapter recodified from COMAR 09.30.75 to COMAR 31.15.07, July 1998. Regulation .02B amended effective January 14, 2010
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