Payment of a clean claim. Within 30 business days after receipt of a claim for benefits under a long-term care insurance policy or certificate, an insurer shall pay such claim if it is a clean claim, or send a written notice acknowledging the date of receipt of the claim and one of the following:

1. (1) The insurer is declining to pay all or part of the claim and each specific reason for the denial; or
2. (2) That additional information is necessary to determine if all or any part of the claim is payable and the specific additional information that is necessary.

Source: 36 SDR 209, effective July 1, 2010.

General Authority: SDCL 58-17B-4 .

Law Implemented: SDCL 58-17B-4 .