Unfair Claim Settlement Practices class3
Superior Insurance Company receives a claim and proof of loss from an insured on April 1. Investigates the claim on April 5 and determines that the claim is valid on April 12. The insured submits additional information in support of the claim on May 1. On what date was Superior first forced to resolve the claim?
April 12th Because An insurer must attempt to settle a claim as soon as the insurer's liability becomes clear.
Unfair claims settlement practices
Commissions paid on policies for which complaints were received Because The record must include the total number of complaints, classified by line of insurance. The record must also specify the nature of each complaint, the disposition, and the time spent processing each complaint.
Which of the following does NOT constitute an unfair claim settlement practice in Texas?
Failure to pay a claim for which the insurer's liability is uncertain. Because An insurer is not required to pay a claim for which its liability has not been established.
Which of the following practices can an insurer adopt to legally resolve their claims?
Require an immediate investigation of a claim, even if the insured has not presented all evidence of loss. Because a practice of promptly investigating a claim, even if the insured has not submitted all evidence of loss, is an acceptable practice for insurers.
The Commissioner issued a cease and desist order against Nether Insurance Company for committing certain practices in resolving claims. Nether ignores the order. The commissioner can refer the case to which of the following for execution?
State Attorney General Because the Commissioner can refer a case to the state attorney general for execution.
The Texas Department of Insurance found that ABT Insurance has not responded promptly to communications from policyholders regarding claims. This means that it normally does not respond within:
15 days Because Insurers must timely acknowledge pertinent communications relating to a claim arising under the insurer's policy within 15 business days. Failing to do so can be considered an unfair claim settlement practice
KLM Insurance has a policy of promptly responding to communications from policyholders regarding claims. Does that mean it probably responds within how many days?
15 days Because not immediately acknowledging pertinent claims-related communications within 15 days is considered an unfair claim settlement practice in Texas.
State Insurance Company keeps a record of all complaints it receives from its policyholders. State is required to maintain this record for no less than:
Three years, or three years since the date of their last examination by the Department, whichever is shorter Because An insurer is required to keep a record of complaints received within the last 3 years, or 3 years since the date of the insurer's last examination by the Department, whichever is shorter.
