Chapter 15 -Unfair Claim Settlement Practice Act

Unfair Claims Settlement Practices No person may commit or perform with such frequency as to indicate a general business practice, any of the following:

• Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds. • Attempting to settle a claim for less than the amount • Attempting to settle claims on the basis of an application which was altered without notice to, or the knowledge of, the insured;

Unfair Claims Settlement Practices No person may commit or perform with such frequency as to indicate a general business practice, any of the following:

• Failing to promptly settle claims, where liability has become reasonably clear. • Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or the offer of a compromise settlement.

Unfair Claims Settlement Practices No person may commit or perform with such frequency as to indicate a general business practice, any of the following:

• Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; • Failing to acknowledge and act reasonably and promptly upon communications with respect to claims arising under insurance policies; • Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies;

Unfair Claims Settlement Practices No person may commit or perform with such frequency as to indicate a general business practice, any of the following:

• Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which payments are being made; • Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration; • Delaying the investigation or payment of claims

Unfair Claims Settlement Practices No person may commit or perform with such frequency as to indicate a general business practice, any of the following:

• Refusing to pay claims without conducting a reasonable investigation based upon all available information; • Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed; • Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear;