44-1540. Unfair claims settlement practice; acts and practices prohibited.

641 words·~3 min read·/ne/chapter-44/44-1540

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Any of the following acts or practices by an insurer, if committed in violation of section 44-1539 , shall be an unfair claims settlement practice:

(1)Knowingly misrepresenting to claimants and insureds relevant facts or policy provisions relating to coverages at issue;

(2)Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;

(3)Failing to adopt and implement reasonable standards for the prompt investigation and settlement of claims arising under its policies;

(4)Not attempting in good faith to effectuate prompt, fair, and equitable settlement of claims submitted in which liability has become reasonably clear;

(5)Not attempting in good faith to effectuate prompt, fair, and equitable settlement of property and casualty claims

(a)in which coverage and the amount of the loss are reasonably clear and

(b)for loss of tangible personal property within real property which is insured by a policy subject to section 44-501.02 and which is wholly destroyed by fire, tornado, windstorm, lightning, or explosion;

(6)Compelling insureds or beneficiaries to institute litigation to recover amounts due under its policies by offering substantially less than the amounts ultimately recovered in litigation brought by them;

(7)Refusing to pay claims without conducting a reasonable investigation;

(8)Failing to affirm or deny coverage of a claim within a reasonable time after having completed its investigation related to such claim;

(9)Attempting to settle a claim for less than the amount to which a reasonable person would believe the insured or beneficiary was entitled by reference to written or printed advertising material accompanying or made part of an application;

(10)Attempting to settle claims on the basis of an application which was materially altered without notice to or knowledge or consent of the insured;

(11)Making a claims payment to an insured or beneficiary without indicating the coverage under which each payment is being made;

(12)Unreasonably delaying the investigation or payment of claims by requiring both a formal proof-of-loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof-of-loss form;

(13)Failing, in the case of the denial of a claim or the offer of a compromise settlement, to promptly provide a reasonable and accurate explanation of the basis for such action;

(14)Failing to provide forms necessary to present claims with reasonable explanations regarding their use within fifteen working days of a request;

(15)Failing to adopt and implement reasonable standards to assure that the repairs of a repairer owned by or affiliated with the insurer are performed in a skillful manner. For purposes of this subdivision, a repairer is affiliated with the insurer if there is a preexisting arrangement, understanding, agreement, or contract between the insurer and repairer for services in connection with claims on policies issued by the insurer;

(16)Requiring the insured or claimant to use a particular company or location for motor vehicle repair. Nothing in this subdivision shall prohibit an insurer from entering into discount agreements with companies and locations for motor vehicle repair or otherwise entering into any business arrangements or affiliations which reduce the cost of motor vehicle repair if the insured or claimant has the right to use a particular company or reasonably available location for motor vehicle repair. If the insured or claimant chooses to use a particular company or location other than the one providing the lowest estimate for like kind and quality motor vehicle repair, the insurer shall not be liable for any cost exceeding the lowest estimate. For purposes of this subdivision, motor vehicle repair shall include motor vehicle glass replacement and motor vehicle glass repair;

(17)Failing to provide coverage information or coordinate benefits pursuant to section 68-928 ; and

(18)Failing to pay interest on any proceeds due on a life insurance policy as required by section 44-3,143 .