Vermont Regulation I-79-2 (Revised): Fair Claims Practices

What this document is

Vermont Regulation I-79-2 (Revised) - Fair Claims Practices is a regulation published by Vermont Department of Financial Regulation. It is one of the Vermont documents that insurance license exam questions are written from, including vermont property & casualty, vermont personal lines 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.

• Regulation I-79-2, Section 5 (Notification time requirements)

  “A. An insurer or its agent who has claim adjusting authority shall mail or orally acknowledge receipt of the claim notice directly to the claimant, within ten (10) business days. If the acknowledgment is made orally, notation of the acknowledgment shall be recorded in the insurer's record or file....”

• Regulation I-79-2, Section 6.C (Time limit for claim settlements)

  “If the insurer needs more time to determine whether a first party claim should be accepted or denied, it shall so notify the first party claimant within fifteen (15) business days after receipt of the proofs of loss giving the reasons more time is needed. Claims governed by 8 V.S.A § 3868 are not...”

• Regulation I-79-2, Section 6.E (Time limit for claim settlements)

  “Insurers shall not continue negotiations for settlement of a claim directly with a claimant who is neither an attorney nor represented by an attorney until the claimant's rights may be affected by a statute of limitations or a policy or contract time limit, without giving the claimant written...”

• Regulation I-79-2, Section 7.D (Standards for fair and equitable settlements)

  “Where liability has become reasonably clear, an insurer is prohibited from withholding payment under one portion of a liability claim in order to influence settlement of another portion of a liability claim.”

• Regulation I-79-2, Section 8.A.6 (Matching of Exterior and Interior Partial Losses)

  “Matching of Exterior and Interior Partial Losses. When a covered loss requires the replacement of an item or items and the replacement item or items do not match adjacent items in quality, color or size, the insurer shall replace such items with material of like kind and quality so as to conform to...”

• Regulation I-79-2, Section 6.A (Time limit for claim settlements; first party acceptance or denial)

  “Within fifteen (15) business days after receipt by the insurer of properly executed proofs of loss, the first party claimant shall be advised of the acceptance or denial of the claim by the insurer. No insurer shall deny a claim on the grounds of a specific policy provision, condition, or exclusion...”

• Regulation I-79-2, Section 6.D (Time limit for claim settlements; responsibility assumed by others)

  “Insurers shall not fail to settle first party claims on the basis that responsibility for payment should be assumed by others except as may otherwise be provided by policy provisions.”

• Regulation I-79-2, Section 8.B.2(f)(ii) (Motor vehicle total losses; definition of local market)

  “"Local market" shall mean an area within a 75-mile radius of the zip code used to identify the place of garaging of the totaled vehicle;”

• Regulation I-79-2, Section 8.A.3 (Adjustment of partial losses; specific repairer)

  “If insurer insists that repairs be done by a specific repairer, said insurer shall guarantee all work performed by said repairer.”

• Regulation I-79-2, Section 6.F (Time limit for claim settlements; statements to third party claimants)

  “No insurer shall make statements which indicate that the rights of a third party claimant may be impaired if a form or release is not completed within a given period of time unless the statement is given for the purpose of notifying the third party claimant of the provision of a statute of limitations.”

• Regulation I-79-2, Section 6.G (Time limit for claim settlements; payment after settlement)

  “After settlement has been agreed upon, insurer shall mail payment in amount agreed to claimant and/or loss payee within ten (10) business days, unless a further delay is mandated under an order by a court of competent jurisdiction or required by law.”

• Regulation I-79-2, Section 7.B (Standards for fair and equitable settlements; explanation of payment)

  “All claim payments shall include an appropriate explanation of the basis of the payment (example, full explanation of all deductions for depreciations, deductibles or coinsurance).”

Practice this material

Questions about this source

More Vermont sources

• Vt. Stat. Ann. tit. 8, ch. 103: Life insurance policy provisionsState statute
• Vt. Stat. tit. 8, s. 4723 - Unfair methods of competition or unfair or deceptive acts or practices prohibitedState statute
• Vt. Stat. tit. 8, s. 4724 - Unfair methods of competition or unfair or deceptive acts or practices definedState statute
• Vt. Stat. tit. 8, s. 4800 - License requirementsState statute
• Vt. Stat. tit. 8, s. 4804 - License denial, nonrenewal, or termination causesState statute
• Vermont Statutes Title 8 Chapter 107 - Health Insurance (Secs. 4011-4093)State statute
• Vermont Producer's Examination for Casualty Insurance (Series 14-42) - Exam Content OutlineCandidate handbook or exam outline
• Vermont Producer's Examination for Life, Accident, Health and HMO - Exam Content Outline (Series 14-29)Candidate handbook or exam outline