58-12-34. Acts constituting unfair claims practices.
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/sd/title-58/chapter-58-12/58-12-34·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Any of the following acts by an insurer, if committed in violation of § 58-12-33 , is an unfair claims practice:
(1)Knowingly misrepresents to a claimant or an insured a relevant fact or policy provision relating to coverages at issue;
(2)Fails to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;
(3)Fails to adopt and implement reasonable standards to promptly complete claim investigations and settlement of claims arising under its policies;
(4)Fails to make a good faith attempt to effectuate prompt, fair, and equitable settlement of claims submitted in which liability coverage, and causation of claims have become reasonably clear;
(5)Compels an insured or beneficiary to institute a suit to recover an amount due under its policies by offering substantially less than the amount ultimately recovered in a suit brought by the insured or beneficiary;
(6)Refuses to pay claims without conducting a reasonable claim investigation;
(7)Fails to affirm or deny coverage of claims within a reasonable time after having completed a claim investigation related to the claim;
(8)Attempts to settle a claim for less than the amount that a reasonable person would believe the insured or beneficiary is entitled by reference to written or printed advertising material accompanying or made part of an application;
(9)Attempts to settle a claim on the basis of an application that was materially altered without notice to, or knowledge or consent of, the insured;
(10)Makes a claim payment to an insured or beneficiary without indicating the coverage under which each payment is being made;
(11)Unreasonably delays a claim investigation or payment of a claim 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;
(12)Fails, in the case of a claim denial or offer of compromise settlement, to promptly provide a reasonable and accurate explanation of the basis for such action; or
(13)Fails to provide forms necessary to present a claim within fifteen days of a request with reasonable explanations regarding their use.