26.1-25.2 Personal Insurance Claims History
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<![CDATA[CHAPTER 26.1-25.2PERSONAL INSURANCE CLAIMS HISTORY26.1-25.2-01. Scope. This chapter applies to only personal insurance.26.1-25.2-02. Definitions. As used in this chapter:1."Deceptive practices" means any misstatement or omission of any material fact, or<br>submission of a false statement, in light of the circumstances under which it was<br>made, by a person acting with the intent to defraud in filing an insurance claim.2."Insurance support organization" means:a.(1)A person who regularly engages, in whole or in part, in the practice of<br>assembling or collecting information about an individual for the primary<br>purpose of providing the information to an insurance institution or<br>insurance producer for an insurance transaction.(2)The term includes the furnishing of consumer reports or investigative<br>consumer reports to an insurance institution or insurance producer for<br>use in connection with an insurance transaction.(3)The term also includes the collection of personal information from an<br>insuranceinstitution,insuranceproducer,orinsurancesupportorganization for the purpose of detecting or preventing fraud, material<br>misrepresentation,ormaterialnondisclosureinconnectionwithinsurance underwriting or insurance claim activity.b.The following persons are not insurance support organizations:(1)Insurance producers.(2)Government institutions.(3)Insurance institutions.(4)Medical care institutions.(5)Medical professionals.3."Personal insurance" means private passenger automobile, homeowner, motorcycle,<br>mobile homeowner, and owner-occupied dwelling fire insurance policies.26.1-25.2-03.Prohibited claims usage.An insurer may not consider the followingevents for purposes of surcharging, declining, nonrenewing, or canceling either personal<br>insurance coverage or a binder for personal insurance coverage. The events include:1.An insured's inquiry into the type or level of coverage or an inquiry into whether a<br>policy will cover a loss;2.An insured's inquiry regarding coverage for a loss if the insured files no claim;3.A claim if the insurer conducts no investigation of a claim or initiates no other claim<br>activity and the claim does not involve deceptive practices on the part of the insured;4.A claim if the insurer makes no payment to or on behalf of the insured and the claim<br>does not involve deceptive practices on the part of the insured;Page No. 15.A first-party property claim resulting from wind or hail if the insured had no previous<br>wind or hail claim on that property within the previous five years regardless of the<br>insurer unless the insurer can provide evidence that the insured unreasonably failed<br>to maintain the property and the failure to maintain the property contributed to the<br>loss; or6.A claim if the claim is over ten years old, unless the insurer can provide evidence<br>that the insured unreasonably failed to maintain the property and the failure to<br>maintain the property contributed to the loss.26.1-25.2-04. Prohibited use of prior owner's history. An insurer may not decline toinsure a property not previously owned by an applicant based solely upon the loss history of a<br>previous owner of the property, unless the insurer can provide evidence that the previous owner<br>did not repair the damage.26.1-25.2-05. Disclosure requirements. An insurer writing personal insurance mustinform the applicant in writing or in the same medium as the application at the time of an<br>application for personal insurance that the insurer will consider the insured's claims history in<br>determining whether to decline, cancel, nonrenew, or surcharge a policy and that a claim<br>incurred by the insured will be reported to an insurance support organization.Page No. 2Document Outlinechapter 26.1-25.2 personal insurance claims history]]>