375.1007. Improper claims practices.
Improper claims practices.
375.1007. Any of the following acts by an insurer, ifcommitted in violation of section 375.1005, constitutes animproper claims practice:
(1) Misrepresenting to claimants and insureds relevantfacts or policy provisions relating to coverages at issue;
(2) Failing to acknowledge with reasonable promptnesspertinent communications with respect to claims arising under itspolicies;
(3) Failing to adopt and implement reasonable standards forthe prompt investigation and settlement of claims arising underits policies;
(4) Not attempting in good faith to effectuate prompt, fairand equitable settlement of claims submitted in which liabilityhas become reasonably clear;
(5) Compelling insureds or beneficiaries to institute suitsto recover amounts due under its policies by offeringsubstantially less than the amounts ultimately recovered in suitsbrought by them;
(6) Refusing to pay claims without conducting a reasonableinvestigation;
(7) Failing to affirm or deny coverage of claims within areasonable time after proof of loss statements have beencompleted and communicated to the insurer;
(8) Attempting to settle a claim for less than the amountto which a reasonable person would believe the insured orbeneficiary was entitled by reference to written or printedadvertising material accompanying or made part of an application;
(9) Attempting to settle claims on the basis of anapplication which was materially altered without notice to, orknowledge or consent of, the insured;
(10) Making a claims payment to an insured or beneficiarywithout indicating the coverage under which each payment is beingmade;
(11) Unreasonably delaying the investigation or payment ofclaims by requiring both a formal proof of loss form andsubsequent verification that would result in duplication ofinformation and verification appearing in the formal proof ofloss form;
(12) Failing in the case of claims denial or offers of acompromise settlement to promptly provide a reasonable andaccurate explanation of the basis for such actions;
(13) Failing to provide forms necessary to present claimswithin fifteen calendar days of a request with reasonableexplanations regarding their use;
(14) Failing to adopt and implement reasonable standards toassure that the repairs of a repairer owned by or required to beused by the insurer are performed in a workmanlike manner;
(15) Failing to promptly settle claims where liability hasbecome reasonably clear under one portion of the insurance policycoverage in order to influence settlements under other portionsof the insurance policy coverage.
(L. 1991 S.B. 53 § 5, A.L. 1993 H.B. 709)