Sec. 09.01.09.09. Notice Requirements for Denial of Coverage

A. Notice of Denial.

(1) The operator of a plan shall notify the buyer in writing of a decision to deny warranty coverage for all or part of a claim not later than 90 days after the claim is received by the operator.

(2) The notice of denial shall include:

(a) Reference to the specific terms of the plan on which the denial is based; and

(b) The procedures which the buyer must follow to appeal the denial, including all time limitations.

B. If the operator is unable to reach a decision on the claim within 90 days, the operator shall:

(1) Before the end of the 90-day period, notify the buyer in writing of the:

(a) Reasons for the inability to meet the deadline, and

(b) Date by which the decision will be reached; and

(2) When a decision on the claim is reached, notify the buyer of a decision to deny warrant coverage in accordance with §A of this regulation.

C. The operator shall send copies of all notifications of denial of coverage to the Secretary at the same time that the notice is sent to the buyer.