It is an unfair claim settlement practice and a violation of this subtitle for an insurer, nonprofit health service plan, or health maintenance organization to:
(1) misrepresent pertinent facts or policy provisions that relate to the claim or coverage at issue;
(2) refuse to pay a claim for an arbitrary or capricious reason based on all available information;
(3) attempt to settle a claim based on an application that is altered without notice to, or the knowledge or consent of, the insured;
(4) fail to include with each claim paid to an insured or beneficiary a statement of the coverage under which payment is being made;
(5) fail to settle a claim promptly whenever liability is reasonably clear under one part of a policy, in order to influence settlements under other parts of the policy;
(6) fail to provide promptly on request a reasonable explanation of the basis for a denial of a claim;
(7) fail to meet the requirements of Title 15, Subtitle 10B of this article for preauthorization for a health care service;
(8) fail to comply with the provisions of Title 15, Subtitle 10A of this article;
(9) fail to act in good faith, as defined under § 27-1001 of this title, in settling a first-party claim under a policy of property and casualty insurance; or
(10) fail to comply with the provisions of § 16-118 of this article.
Credits
Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997. Amended by Acts 1998, c. 111, § 2, eff. Jan. 1, 1999; Acts 1998, c. 111, § 2, eff. Jan. 1, 1999; Acts 2007, c. 150, § 1, eff. Oct. 1, 2007; Acts 2012, c. 171, § 1, eff. Oct. 1, 2013; Acts 2014, c. 355, § 2, eff. June 1, 2014.
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
