Title 31A, Title 31A: Insurance Code

31A-26-216. Portable electronics adjusting. (1) As used in this section, "automated claims adjudication system" means a preprogrammed computer system designed for the collection, data entry, calculation, and final resolution of a portable electronics insurance claim that: may onl…

31A-26-301. Timely payment of claims. (1) Unless otherwise provided by law, an insurer shall timely pay every valid insurance claim made by an insured. By rule the commissioner may prescribe: the kinds of notice and proof of loss that will establish validity; the manner in which …

31A-26-301.5. Health care claims practices. (1) Except as provided in Section, an insured retains ultimate responsibility for paying for health care services the insured receives. 31A-8-407 If a health care service is covered by one or more individual or group health insurance po…

31A-26-301.6. Health care claims practices. (1) As used in this section: "Health care provider" means a person licensed to provide health care under: Title 26B, Chapter 2, Part 2, Health Care Facility Licensing and Inspection; or Title 58, Occupations and Professions. "Insurer" m…

31A-26-301.7. Dental claim transparency and practices. (1) As used in this section: "Bundling" means the practice of combining distinct dental procedures into one procedure for billing purposes. "Dental plan" means the same as that term is defined in Section. 31A-22-646 "Downcodi…

31A-26-301.8. Non-covered dental services and claims documentation. (1) Terms defined in Sectionapply to this section. 31A-26-301.7 (2) An insurer may not require a dental provider to submit the dental provider's full fee-for-service charges on a claim form as a condition of paym…

31A-26-302. Settlement of claims in credit life and accident and health insurance. (1) The creditor shall promptly report all claims to the insurer or its designated claim representative. The insurer shall maintain adequate claims files. All claims shall be settled as soon as pos…

31A-26-303. Unfair claim settlement practices. (1) No insurer or person representing an insurer may engage in any unfair claim settlement practice under Subsections,, and. (2) (3) (4) (2) Each of the following acts is an unfair claim settlement practice: knowingly misrepresenting…

31A-26-304. Prohibition of conflicting roles. A person licensed concurrently as both an independent and a public adjuster may not represent both the insurer and the insured in the same transaction.

31A-26-305. Request for accepted check. If an insurance policy claimant entitled to receive money in settlement of a claim makes a timely request to the insurer for payment by accepted check, the insurer shall make payment to the claimant with a check accepted by the drawee under…

31A-26-306. Place of business -- Records. (1) An insurance adjuster licensed under this chapter shall register and maintain with the commissioner: the address and telephone number of the licensee's principal place of business; a valid business email address at which the commissio…

31A-26-307. Claim reports to commissioner. On the commissioner's request, any insurer or licensed adjuster connected with a loss or claim shall report to the commissioner all facts relative to the loss or claim arising under any insurance contract covering a subject of insurance …

31A-26-308. Settlement of liability insurance claim not admission of liability. No settlement or partial settlement of a claim against any insured under a liability insurance policy is an admission, by either the insured or the insurer, of the liability of the insured on any clai…

31A-26-309. Adjuster's duty to report illegal insurance. Sectionapplies to the adjuster's duty to report illegal insurance.

31A-26-310. Compensation of insurer's or insured's claims adjuster. (1) Except as provided in Subsection, an insurer or an insured may not pay a person who is representing the insurer or insured in connection with an insurance claim adjustment on any basis that is dependent, in w…

31A-26-311. Rescission of contracts with public adjusters. (1) Except as provided in Subsection, an insured or claimant under an insurance policy who contracts with a public adjuster to assist in the settlement of a claim may rescind that contract by delivering written notice of …

31A-26-312. Prohibited conduct. (1) An independent adjuster or public adjuster may not: participate directly or indirectly in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the independent adjuster or public adjuster; eng…

31A-26-313. Health care collection actions -- Notification required. (1) As used in this section: "Collection action" means any action taken to recover funds that are past due or accounts that are in default: for health care services; and that directly results in an adverse repor…

31A-26-401. Required contracts. (1) A public adjuster may not, directly or indirectly, act within this state as a public adjuster without having first entered into a contract, in writing, on a form a public adjuster files with the department in accordance with Section, that the p…

31A-26-402. Compensation. (1) Except as provided by Subsection, a public adjuster may receive compensation for service a public adjuster provides under this chapter consisting of: (4) an hourly fee; a flat rate; a percentage of the total amount an insurer pays to resolve a claim;…

31A-26-403.1. Assignment of property insurance policy rights and benefits. (1) A property insurance policy may prohibit the assignment of a right or benefit under the property insurance policy to a property repair contractor, roofing company, disaster clean up company, appraiser,…

31A-26-404. Funds that a public adjuster holds. A public adjuster that receives, accepts, or holds funds on behalf of an insured shall deposit the funds into a trust account within a federally insured depository institution that: (1) has a branch in this state, if the public adju…

31A-26-405. Public adjuster standards of conduct. A public adjuster may not: (1) solicit or attempt to solicit an insured during the progress of a loss-producing occurrence; (2) advertise or infer damage unless an inspection of the property has been completed; (3) offer to pay an…

31A-26-406. Record retention requirements. (1) A public adjuster shall keep at the public adjuster's address that the public adjuster registers with the commissioner a record of each investigation, adjustment, or transaction the public adjuster undertakes or completes under the p…

31A-26-407. Rulemaking. The commissioner may make rules, in accordance with: (1) addressing the forms required by this part; (2) providing for notice requirements in contracts; and (3) establishing the scope of a contract a public adjuster enters into with an insured that the pub…

31A-27-501. Title -- Construction -- Commissioner's powers. (1) This chapter is known as the "Delinquency Administrative Action Provisions." (2) The proceedings authorized by this part may be applied to: all insurers and reinsurers: who are doing, or have done, an insurance busin…

31A-27-502. Definitions. As used in this part, "record" is as defined in Section.

31A-27-503. Commissioner's administrative actions. (1) The commissioner may take an action described in Subsectionwhenever the commissioner has reasonable cause to believe, and determines after a hearing that an insurer: (1)(b) has committed or engaged in an act, practice, or tra…

31A-27-504. Conduct of hearings. (1) The commissioner shall hold a hearing conducted under Sectionprivately unless the insurer requests a public hearing. 31A-27-503 (2) All records of the insurer, other documents, and all department files and papers, so far as they pertain to or …

31A-27a-101. Title -- Construction -- Commissioner's powers. (1) This chapter is known as the "Insurer Receivership Act." (2) The proceedings authorized by this chapter may be applied to: all insurers and reinsurers: who are doing, or have done, an insurance business in this stat…

31A-27a-102. Definitions. As used in this chapter: (1) "Admitted assets" is as defined by and is measured in accordance with the National Association of Insurance Commissioner's Statements of Statutory Accounting Principles, as incorporated in this state by rules made by the depa…

31A-27a-103. Insurer receivership laws. (1) The state's insurer receivership laws consists of: this chapter; and. Chapter 28, Guaranty Associations (2) The laws listed in Subsectionshall be construed together in a manner that is consistent. (1)

31A-27a-104. Persons covered. (1) This chapter applies to: an insurer who: is doing, or has done, an insurance business in this state; and against whom a claim arising from that business may exist; a person subject to examination by the commissioner; an insurer who purports to do…

31A-27a-105. Jurisdiction. (1) A delinquency proceeding under this chapter may not be commenced by a person other than the commissioner of this state. No court has jurisdiction to entertain, hear, or determine a delinquency proceeding commenced by any person other than the commis…

31A-27a-106. Exemption from fees. The receiver may not be required to pay any of the following fees to a public officer of this state: (1) filing fees; (2) recording fees; (3) transcript fees; (4) copying fees; (5) certification fees; or (6) authentication fees.

31A-27a-107. Notice and hearing on matters submitted by the receiver for receivership court approval. (1) Upon written request to the receiver, a person shall be placed on the service list to receive notice of matters filed by the receiver. The person shall include in a written r…

31A-27a-108. Injunctions and orders. (1) The receivership court may issue an order, process, or judgment including stays, injunctions, or other orders necessary or appropriate to carry out: this chapter; or an approved rehabilitation plan. (2) This chapter may not be construed to…

31A-27a-108.1. Injunctions and orders applicable to a federal home loan bank. (1) As used in this section: "Federal home loan bank" means the same as that term is defined in 12 U.S.C. Sec. 1422. "Insurer-member" means an insurer that is a member as defined in 12 U.S.C. Sec. 1422.…

31A-27a-109. Statutes of limitations. (1) If applicable law, an order, or an agreement fixes a period within which the insurer may commence an action, and this period is not expired before the day on which the initial petition in a delinquency proceeding is filed, the receiver ma…

31A-27a-110. Cooperation of officers, owners, and employees. (1) As used in this section: "Cooperate" includes to: reply promptly in writing to an inquiry from the commissioner or receiver requesting a reply; and promptly make available to the commissioner or receiver any record,…

31A-27a-111. Actions by and against the receiver. (1) An allegation by the receiver of improper or fraudulent conduct against a person may not be the basis of a defense to the enforcement of a contractual obligation owed to the insurer by a third party. Notwithstanding Subsection…

31A-27a-112. Unrecorded obligations and defenses of affiliates. (1) This section applies to a person who in relation to an insurer is: an affiliate; a controlled or controlling person; or a present or former officer, manager, director, trustee, or shareholder. (2) In a proceeding…

31A-27a-113. Executory contracts. (1) Subject to the other provisions of this section, the receiver may assume or reject an executory contract or unexpired lease of the insurer. (2) If there is a default in an executory contract or unexpired lease of the insurer, the receiver may…

31A-27a-114. Immunity and indemnification. (1) For purposes of this section: "Receiver's assistant" includes: a present or former special deputy or assistant special deputy engaged by contract or otherwise; a person whom the receiver, a special deputy, or an assistant special dep…

31A-27a-115. Approval and payment of expenses. (1) The receiver may pay an expense under a contract, lease, employment agreement, or other arrangement entered into by the insurer before receivership, as the receiver considers necessary for the purposes of this chapter. The receiv…

31A-27a-116. Financial reporting. (1) The receiver shall comply with all requirements for receivership financial reporting in this section and as may be specified by the commissioner by rule or ordered by the court within: 180 days after the day on which the receivership court en…