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§ 14-136. Unfair and discriminatory trade practices and other prohibited acts

West's Annotated Code of MarylandInsurance

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 14. Entities that Act as Health Insurers
Subtitle 1. Nonprofit Health Service Plans (Refs & Annos)
Part VI. Prohibited Acts; Penalties
MD Code, Insurance, § 14-136
§ 14-136. Unfair and discriminatory trade practices and other prohibited acts
Currentness
Nonprofit health service plans subject to Title 27
(a) Nonprofit health service plans are subject to Title 27 of this article.
Unfair and discriminatory trade practices and other prohibited acts
(b) A corporation authorized under this subtitle that maintains or operates a nonprofit health service plan may not:
(1) deny a claim made under a contract, certificate, or policy of a nonprofit health service plan for an unfair or unfairly discriminatory reason;
(2) without just cause, require a person making a claim under a contract, certificate, or policy of a nonprofit health service plan to accept less than the amount due; or
(3) fail to notify in writing a subscriber or certificate holder of a nonprofit health service plan of a denial of a properly completed claim within 60 days after the plan receives the claim.
Burden of persuasion on corporation to show act or practice not violation
(c) If it appears to the Commissioner that an act or practice or proposed act or practice of a corporation authorized under this subtitle that maintains or operates a nonprofit health service plan is in violation of subsection (b) of this section or Title 27 of this article, the burden of persuasion is on the corporation to show that the act or practice or proposed act or practice is not in violation of subsection (b) of this section or Title 27 of this article.

Credits

Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, § 354A-1.
MD Code, Insurance, § 14-136, MD INSURANCE § 14-136
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.
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