Fair Claims Practices

Maintain all files -- open or closed for inspection by the Department of Insurance

Current year and four preceding years (five years) § 2695.3(b)(1)(3)

Acknowledge Receipt of Notice of Claim.15 calendar days from receipt. § 2695.5 (a)

Respond to oral or written inquiry from Department of Insurance 21 calendar days of receipt of the inquiry § 2695.5 (f)

Respond to any communication from a claimant regarding a claim that reasonably suggests a response is expected. 15 calendar days after receipt. § 2695.5 (g)

Provide necessary claim forms, instructions and reasonable assistance, except in cases where the first notice of claim is a notice of legal action. Immediately, but in no event more than 15 calendar days with respect to personal policies. § 2695.5 (h)

Provide necessary claim forms, instructions and reasonable assistance, except in cases where the first notice of claim is a notice of legal action. Immediately, but in no event more than 21 calendar days with respect to bonds. § 2695.5 (h)

Begin any necessary investigation of the claim. Immediately, but in no event more than 15 calendar days later. § 2695.6(a)

Adopt, and communicate to its insurance agents and claims agents, written standards for the prompt investigation and processing of claims. 90 days after the effective date -- April 14, 1993. § 2695.6(b)

After receipt of Proof of Claim accept or deny the claim, in whole or in part, and affirm or deny liability. Immediately, but in no event more than 40 calendar days later. § 2695.7(b)

Give notice and Explain inability to affirm or deny coverage in writing. 40 days after proof of claim and every 30 calendar days thereafter. §2695.7(c)

Give notice of running of statute of limitations or private limitation of action -- Unless represented by counsel. At least 60 days before the date on which the limit is to expire. § 2695.7(f)

Give notice of running of statute of limitation or private limitation of action to a first party claimant in a matter relating to an uninsured motorist -- unless represented by counsel. At least 30 calendar days before the date on which the limit is to expire. § 2695.7(f)

Tender payment after the insurer's affirmation of coverage with respect to first party claimants. Immediately, but in no event more than 30 calendar days after. § 2695.7(h)

Tender payment after the insurer's affirmation of coverage and liability with respect to third party claimants, of the amount of the claim which has been determined and is not in dispute, and when, if necessary, the claimant has provided a properly executed release. Immediately, but in no event more than 30 Calendar days after. § 2695.7 (h)