New Hampshire Administrative Code

(a) The business unit is responsible for general office matters, which include: (1) Federal grants accounting; (2) Project management; (3) Health reform coordination; (4) Requisitioning of supplies and equipment; (5) Agency budget preparation; (6) Information technology initiativ…

(a) In accordance with RSA 400-A:6, VII, the chief life, accident, and health actuary is responsible for: (1) Reviewing actuarial aspects of policy form and rate filings to determine that premium rates are not excessive, inadequate, or unfairly discriminatory and that premium rat…

(a) The life and health division is comprised of the life and health market conduct examinations unit, the life and health form examinations unit, the life and health rates unit, and the health data analytics unit. (b) The life and health market conduct examinations unit is descr…

(a) The life and health division is comprised of the life and health market conduct examinations unit and the life and health form examinations unit. (b) The life and health market conduct examinations unit is described as follows: (1) The market conduct examinations division per…

(a) The property and casualty division is comprised of the property and casualty market conduct examinations unit, the property and casualty forms examinations unit, and the property and casualty actuarial unit. (b) The property and casualty market conduct examinations unit is de…

(a) The property and casualty division is comprised of the property and casualty market conduct examinations unit and the property and casualty form examinations unit. (b) The property and casualty market conduct examinations unit is described as follows: (1) The property and cas…

(a) The communications director manages the consumer services division in accordance with RSA 400-A:6, VII. (b) The consumer services division investigates complaints and responds to inquiries received relating to any entity subject to the regulatory authority of the commissioner…

(a) Requests for copies of department documents or records shall be made pursuant to RSA 91-A. (b) All requests for copies of department documents or records shall be in a manner that would give the department notice of exactly what records the requestor is seeking, including the…

(a) The department shall respond to all requests for records as soon as practicable and in accordance with RSA 91-A. (b) When inspection of publicly available records is not immediately feasible, the requesting party and the department shall agree upon a mutually convenient time …

(a) Every insurer, upon notice of a claim, shall acknowledge the receipt of such notice in writing within 10 working days. This requirement of written acknowledgment shall not preclude a speedier method of acknowledgment where the circumstances warrant. Notification given to an a…

(a) A complete decision regarding member payment or coverage or denial shall be made by the insurer within 30 days of receipt of any health insurance claim. In the event of extenuating circumstances, if a complete coverage decision is not made within 30 days, the insurer shall pr…

(a) If a claim is denied in whole or in part the insured, claimant or authorized representative of either shall be given the reason for the denial. In any case where coverage is denied the insurer shall notify the insured, claimant, or authorized representative of either of the a…

In any case where there is no dispute as to one or more elements of the claim, an offer of settlement for such undisputed elements shall be made without prejudice to either party notwithstanding the existence of disputes as to other elements of the claim. Notes N.H. Admin. Code §…

Any notice rejecting a claim in whole or in part shall contain the following statement: "We will, of course, be available to you to discuss the position we have taken and answer your questions. You may reach us by calling the customer service number located in this notice or the …

No insurer shall refuse to grant advance payments on a claim because the claimant, insured or authorized representative of either has retained an attorney for the purpose of facilitating recovery on his behalf. Notes N.H. Admin. Code § Ins 1001.06 #1900, eff 1-1-82; ss by #4287, …

Unless otherwise provided by law, when a disability benefits claim has been accepted by an insurer under either an individual accident and health policy or group policy, the insurer shall not require additional reports from the insured's or beneficiary's physician to substantiate…

No insurer shall employ or otherwise utilize the services of an adjuster unless that adjuster has complied with all the appropriate licensing provisions of RSA 402-B or has been granted a temporary license pursuant to RSA 402-B:11. However, any claim adjusted to the satisfaction …

Every insurer shall provide telephone facilities whereby the insured, claimant, or authorized representative of either can, without expense, contact the company claims office handling the particular claim. If the company has no claims office located in New Hampshire or in the reg…

(a) If, under the provisions of RSA 417:4, XV(a)(12), the insured fails or refuses to submit a report of the loss to the insurer, this shall be considered to be a request by the insured not to pay the claim. (b) The insurer shall adjust all claims in accordance with the provision…

Any insurer or representative thereof who shall knowingly violate any provision of this part shall be subject to the provisions of RSA 400-A;15, III. Notes N.H. Admin. Code § Ins 1001.11 #1900, eff 1-1-82; ss by #4287, eff 7-1-87; ss by #5649, eff 7-1-93; ss and moved by #6999, e…

(a) The purpose of this part, unless otherwise provided by law, is to establish claim settlement standards for all property and casualty insurance, except workers' compensation and policies for large commercial policyholders as defined in RSA 412:3, XI. (b) This part shall apply …

(a) "Claim file" means the complete and specific claim file record of events and dates maintained to show clearly the inception, handling, and disposition of each claim. (b) "Claimant" means any person who sustains bodily injury or property damage and who asserts a right to recov…

(a) Unless otherwise specified, all time periods referenced in this part shall be calendar days. (b) Computation of any period of time referred to in this part shall begin with the day after the action which sets the time period in motion, and shall include the last day of the pe…

(a) Notice of a claim given by an insured or claimant to an insurer's appointed producer shall be considered notification to the insurer, unless: (1) Otherwise provided by law or the policy; or (2) The appointed producer notifies the insured or claimant within 5 working days of r…

(a) Unless otherwise provided by law, every insurer shall establish procedures to: (1) Commence an investigation of any notice of a claim filed by an insured or claimant not later than 5 working days from receipt of the notice of a claim; and (2) Anticipate the seasonal changes i…

(a) In addition to the provisions of Ins 1002.05, if a claim is denied in whole or in part, the insured or claimant shall be given a written notice of the reason for the denial and any applicable policy provision upon which denial is based, provided, however, that if the reason f…

In any case where there is no dispute as to one or more elements of the claim, an offer of settlement for such undisputed elements shall be made without prejudice to either party notwithstanding the existence of disputes as to other elements of the claim. Notes N.H. Admin. Code §…

(a) No insurer shall refuse to grant advance payments on a claim because the insured or claimant has retained an attorney for the purpose of facilitating recovery on his or her behalf. (b) The form of payment of a claim shall allow the claimant or insured ready access to claim fu…

When the insured's or claimant's property has been determined to be a total loss, and there is no dispute concerning liability or coverage, and the provisions of RSA 407:11 do not apply, insurers attempting to establish the value of the property shall: (a) Value the property in t…

No insurer shall employ or otherwise utilize the services of an adjuster unless that adjuster has complied with all the appropriate licensing provisions of RSA 402-B or has been granted a temporary license pursuant to RSA 402-B:11, however, any claim adjusted to the satisfaction …

To facilitate communication, every insurer shall provide a toll-free telephone number on all forms or correspondence, and if it chooses to do so, a facsimile number and/or e-mail address whereby the insured or claimant can contact the company claims office, independent adjuster, …

(a) Prior to concluding that there is no coverage for the loss as a result of the insured's failure to comply with any obligation imposed on the insured under the policy, the insurer shall: (1) Establish that the breach was a material breach that excuses the insurer from performa…

In all motor vehicle property damage liability claims when liability has become clear the insurer shall immediately inform the claimant that coverage exists for the rental of a motor vehicle that is of like kind and quality for the time period necessary for repair, provided howev…

The insured or claimant shall only be responsible for the cost of one damage estimate for motor vehicle property damage liability and collision and comprehensive claims. The insurer shall be responsible for any charge incurred by the insured or claimant for any subsequent damage …

(a) In adjusting motor vehicle total loss property damage liability and collision and comprehensive damage claims for actual cash value, insurers shall determine total losses consistent with the RSA 261:22, VI standards and settlements based upon the motor vehicle's fair market v…

(a) Every settlement offer that is based upon an appraisal conducted on behalf of the insurer relative to property and liability insurance shall: (1) Include a written statement that, if the claimant or insured cannot find a contractor or repairer to do the repair or replace the …

(a) Every settlement offer that is based upon an appraisal conducted on behalf of the insurer relative to property and liability insurance shall: (1) Represent the fair and reasonable price in the area charged by repair shops or facilities providing similar services with the usua…

(a) In addition to any other requirements set forth in this part, every settlement made or offered by the insurer to replace or repair lost or damaged jewelry, watches, precious, or semi-precious stones, under applicable property insurance, shall also: (1) Be based upon an apprai…

(a) Pursuant to RSA 412:8, III, an insurer shall not apply an insured's collision deductible when the damage is: (1) Caused by an uninsured motor vehicle; (2) The operator of the uninsured motor vehicle has been positively identified; and (3) The operator of the uninsured motor v…

Every insurer shall maintain in its files, in either written or electronic form, physical evidence of compliance with all of the provisions of this part and RSA 400-B. Notes N.H. Admin. Code § Ins 1002.20 #8900, eff 7-1-07; renumbered by #9495 (from Ins 1002.19) Amended by Volume…

Any insurer or representative thereof who shall knowingly violate any provision of this part shall be subject to the provisions of RSA 400-A:15, III. Notes N.H. Admin. Code § Ins 1002.21 #8900, eff 7-1-07; renumbered by #9495 (from Ins 1002.20 ) Amended by Volume XXXV Number 45, …

The purpose of this chapter is to establish rules whereby all human immunodeficiency virus test results and records pertaining to such test results shall be maintained as confidential and be protected against inadvertent or unwarranted intrusion. This chapter shall also give effe…

This chapter shall apply to all insurers, their producers and any other person engaged in the business of insurance in this state who, in connection with an application for insurance, require an individual applying for insurance or for any increased or additional insurance benefi…

(a) "Antibody" means a protein produced by the body in response to specific foreign substances such as bacteria or viruses. (b) "Antigen" means a substance that stimulates the production of antibodies. (c) "Human Immunodeficiency Virus" (HIV) means the virus, or its variants, whi…

(a) No insurer shall test any individual in connection with an application for insurance or for any increased or additional benefits for the presence of an antibody or antigen to a human immunodeficiency virus unless such individual gives written consent on a form created by the …

(a) All information in the possession of or available to an insurer regarding the results of any test for the human immunodeficiency virus shall be maintained as confidential information and shall be protected against inadvertent or unwarranted intrusion. The insurer shall take a…

Any insurer, producer or any other person violating any of the provisions of this rule shall be subject to the penalties provided in RSA 400-A:15, III. Notes N.H. Admin. Code § Ins 1103.03 #6953, eff 3-1-99 (formerly Ins 1101.07); ss by #8826, eff 3-1-07 Amended by Volume XXXV Nu…