Sec. 31.15.08.05. Claims Registers  


Latest version.
  • A. Each insurer shall maintain claims registers separated for:

    (1) Annuity contracts and life insurance policies, excluding credit life insurance;

    (2) Health insurance policies, excluding credit health insurance; and

    (3) Credit life insurance and credit health insurance policies.

    B. Claims registers may be maintained manually or on computer-generated tapes from which hard copy can be supplied.

    C. Claims registers shall list each claim received, showing the:

    (1) Date of receipt;

    (2) Policy or contract number;

    (3) Name of the insured;

    (4) General nature of the claim; and

    (5) State of residence of the claimant.

    D. Each claim shall be assigned a unique claim number.

    E. If a claim is closed but subsequently reopened, the original claim number shall continue to be used.

    F. Each claim shall be considered a single claim regardless of the number of times it has been closed and reopened.

    G. Payments made to a claimant on an ongoing basis shall be recorded under the original claim number and considered a single claim for purposes of these regulations.

    H. The Commissioner may grant permission to an insurer to use an alternate claim numbering system upon submission by the insurer of proof satisfactory to the Commissioner that the requirements of E, F, and G of this regulation are impracticable or unduly burdensome to the insured.

    I. Claims registers, in original form or reproduced from computer data, shall be available for inspection by the Insurance Commissioner or by persons designated by the Commissioner for a period of at least 5 years following the date of filing of a claim.