A delivery driver for a logistics company accidentally strikes a parked vehicle, causing significant body damage. The owner of the parked car promptly submits a complete third-party liability claim to the logistics company's auto insurer, including repair estimates and the police report. Seventy-five days pass, and the auto insurer has neither affirmed liability, denied the claim, nor sent any written communication explaining why more time is needed to make a decision.
Based on NAIC Unfair Claims Settlement Practices standards, which assessment of the auto insurer's conduct is correct?
- The insurer has committed a violation by failing to affirm or deny coverage within a reasonable time after receiving the necessary claim information.Cevap
- BThe insurer is acting compliantly because third-party liability investigations legally permit an extended 90-day review period without requiring interim updates.
- CThe lack of communication is considered an acceptable administrative delay as long as the eventual settlement includes statutory interest.
- DThe insurer is following standard protocol because timeline regulations only apply to first-party claims, not third-party liability claims.
Cevap
The insurer has committed a violation by failing to affirm or deny coverage within a reasonable time after receiving the necessary claim information.
Under Unfair Claims Settlement Practices laws, insurers are strictly required to affirm or deny coverage within a reasonable timeframe (typically 15-30 days) after receiving the necessary claim information. If they cannot make a decision immediately, they must send a letter explaining the delay. Ignoring the claimant for 75 days is a direct violation of these statutes.
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Timely Communication and Decisions in Claims Handling
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