1. (1) concealing from or failing to fully disclose to a claimant a benefit, limitation, exclusion, coverage, or other relevant provision of a contract or policy under which a claim is presented;
2. (2) denying or threatening to deny a claim, rescinding, canceling, or threatening to rescind or cancel coverage under a policy for a reason that is not clearly described in the contract or policy as a reason for denial, cancellation, or rescission;
3. (3) refusing to settle a claim without conducting a reasonable investigation;
4. (4) refusing to provide a written basis for denying a claim upon demand of a claimant;
5. (5) failing to provide a claimant with a written explanation of the evidence of an investigation or the claim file materials supporting a denial of a claim based on misrepresentation or fraud, if misrepresentation or fraud is the basis for the denial;
6. (6) compensating an employee, producer, or contractor an amount based on savings to the insurer due to reducing or denying a claim;
7. (7) making a claim settlement to a claimant without a statement or explanation that describes the coverage under which the settlement is made and how the settlement amount was calculated;
8. (8) failing to settle a claim following receipt of a proof of loss if liability is reasonably clear to influence another claim settlement under another portion of the policy or under another policy;

9. (9) advising a claimant not to obtain the services of an attorney or other advocate, or suggesting a claimant will receive less money if an attorney is used to:

   1. (a) pursue a claim; or
   2. (b) advise on the merits of a claim;
10. (10) misleading a claimant about applicable statutes of limitation;
11. (11) issuing a check or a draft in partial settlement that contains language that releases an insurer from total liability;

12. (12)(a) a policy issued before May 5, 2008, that fails to pay interest at the legal rate, under Title 15, Chapter 1, Interest, on an amount that is overdue;

    1. (b) a claim is overdue if not settled within 15 days of completing the investigation; and
13. (13) a policy issued on or after May 5, 2008, that fails to pay interest under Section 31A-22-428.

The commissioner finds that the following acts or general business practices are unfair claim settlement practices and are misleading, deceptive, unfairly discriminatory, overreaching, or an unreasonable restraint on competition:

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