Arkansas Insurance Department Rule on Unfair Claims Settlement Practices, 23 CAR pt. 15 (REGULATION, not Ark. Code Ann.)

What this document is

Arkansas Insurance Department Rule on Unfair Claims Settlement Practices, 23 CAR pt. 15 (REGULATION, not Ark. Code Ann.) is a regulation published by Arkansas Insurance Department, Code of Arkansas Rules. It is one of the Arkansas documents that insurance license exam questions are written from, including arkansas life & health, arkansas property & casualty practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• 23 CAR pt. 15 § 15-105(b)(1) (Failure to acknowledge pertinent communications)

  “Every insurer, upon receiving notification of a claim shall, within fifteen (15) working days, acknowledge the receipt of such notice unless payment is made within such period of time.”

• 23 CAR pt. 15 § 15-105(e) (Failure to acknowledge pertinent communications)

  “Every insurer, upon receiving notification of a claim, shall promptly provide necessary claim forms, instructions, and reasonable assistance to claimants so that first-party claimants can comply with the policy conditions and the insurer's reasonable requirements.”

• 23 CAR pt. 15 § 15-107(b)(1)(B) (Standards for prompt, fair, and equitable settlements applicable to insurers)

  “No insurer shall deny a claim on the grounds of a specific policy provision, condition, or exclusion unless reference to such provision, condition, or exclusion is included in the denial.”

• 23 CAR pt. 15 § 15-101(a) (Purpose)

  “The purpose of this rule is to define certain minimum standards which, if violated with such frequency as to indicate a general business practice, will be deemed to constitute unfair claims settlement practices.”

• 23 CAR pt. 15 § 15-106(b)(2) (Standards for prompt investigation of claims)

  “If an investigation cannot be completed within the forty-five-day time period, insurers shall notify claimants that additional time is required and include with such notification the reasons therefore.”

• 23 CAR pt. 15 § 15-104 (File and record documentation)

  “(a) The claim files of insurers, including health carriers, shall be subject to examination by the Insurance Commissioner or by his or her duly appointed designees. (b) Such files shall contain all notes and work papers pertaining to the claim in such detail that pertinent events and the dates of...”

• 23 CAR pt. 15 § 15-101(a) (Purpose, minimum standards)

  “(a) The purpose of this rule is to define certain minimum standards which, if violated with such frequency as to indicate a general business practice, will be deemed to constitute unfair claims settlement practices.”

• 23 CAR pt. 15 § 15-105(e) (duty to provide claim forms and assistance)

  “(e) Every insurer, upon receiving notification of a claim, shall promptly provide necessary claim forms, instructions, and reasonable assistance to claimants so that first-party claimants can comply with the policy conditions and the insurer's reasonable requirements.”

• 23 CAR pt. 15 § 15-105(b)(3) (notification to an agent of an insurer)

  “(3) Notification given to an agent of an insurer shall be notification to the insurer.”

• 23 CAR pt. 15 § 15-105(b)(5) (proof of loss forms)

  “(5) Insurers shall not require a claimant to calculate depreciated value of personal property on forms for proof of loss.”

• 23 CAR pt. 15 s. 15-110(b) and (c) (Processing of clean claims)

  “(b) A health carrier shall pay or deny a clean claim within: (1) Thirty (30) days after receipt by the health carrier if the claim was submitted electronically; or (2) Forty-five (45) days after receipt if the claim was submitted by other means. (c) A health carrier shall notify the health claimant...”

• 23 CAR pt. 15 § 15-105(b)(3) and (b)(4) (Failure to acknowledge pertinent communications)

  “Notification given to an agent of an insurer shall be notification to the insurer. (4) Pursuant to Arkansas Code § 23-79-126, insurers shall furnish forms for proof of loss within twenty (20) calendar days after a loss has been reported, or thereafter waive proof of loss requirements.”

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