- (1) "Authorized agent" means an individual, corporation, association, organization, partnership, or other legal entity authorized to represent an insurer with respect to a claim.
- (2) "Beneficiary" means a party entitled to receive proceeds or benefits under a contract or policy.
- (3) "Claim file" means a record that can accurately and reliably reproduce the original material regarding a claim, its investigation, adjustment, and settlement.
- (4) "Claimant" means an insured or an insured's legal representative, including an immediate family member designated by the insured.
- (5) "Days" means calendar days.
- (6) "Documentation" means a physical or an electronic record related to a claim.
- (7) "General business practice" means a pattern of conduct in a business.
- (8) "Investigation" means an activity of an insurer related to the determination of liability of a claim.
- (9) "Notice of loss" means a claimant's notice that reasonably informs an insurer of the facts related to a claim.
- (10) "Proof of loss" means a claimant's reasonable documentation in support of a claim.
Terms used in this rule are defined in Section 31A-1-301. Additional terms are defined as follows:
KEY: insurance law
Date of Last Change: August 22, 2023
Notice of Continuation: April 3, 2024
Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-2-204; 31A-2-308; 31A-21-312; 31A-22-428; 31A-26-301; 31A-26-303