Section 21.36.125. Unfair claim settlement practices.

   (a) A person may not commit any of the following acts or practices:
        (1) misrepresent facts or policy provisions relating to coverage of an insurance policy;
        (2) fail to acknowledge and act promptly upon communications regarding a claim arising under an insurance policy;
        (3) fail to adopt and implement reasonable standards for prompt investigation of claims;
        (4) refuse to pay a claim without a reasonable investigation of all of the available information and an explanation of the basis for denial of the claim or for an offer of compromise settlement;
        (5) fail to affirm or deny coverage of claims within a reasonable time of the completion of proof-of-loss statements;
        (6) fail to attempt in good faith to make prompt and equitable settlement of claims in which liability is reasonably clear;
        (7) engage in a pattern or practice of compelling insureds to litigate for recovery of amounts due under insurance policies by offering substantially less than the amounts ultimately recovered in actions brought by those insureds;
        (8) compel an insured or third-party claimant in a case in which liability is clear to litigate for recovery of an amount due under an insurance policy by offering an amount that does not have an objectively reasonable basis in law and fact and that has not been documented in the insurer's file;
        (9) attempt to make an unreasonably low settlement by reference to printed advertising matter accompanying or included in an application;
        (10) attempt to settle a claim on the basis of an application that has been altered without the consent of the insured;
        (11) make a claims payment without including a statement of the coverage under which the payment is made;
        (12) make known to an insured or third-party claimant a policy of appealing from an arbitration award in favor of an insured or third-party claimant for the purpose of compelling the insured or third-party claimant to accept a settlement or compromise less than the amount awarded in arbitration;
        (13) delay investigation or payment of claims by requiring submission of unnecessary or substantially repetitive claims reports and proof-of-loss forms;
        (14) fail to promptly settle claims under one portion of a policy for the purpose of influencing settlements under other portions of the policy;
        (15) fail to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; or
        (16) offer a form of settlement or pay a judgment in any manner prohibited by AS 21.96.030;
        (17) violate a provision contained in AS 21.07.
   (b) The provisions of this section do not create or imply a private cause of action for a violation of this section.
   (c) The director of insurance shall adopt regulations to implement, define, and enforce this section.

Authorities

21.36.350;21.36.910;23.30.155

Notes

Implemented As

3 AAC 23.745
3 AAC 23.820
3 AAC 23.830
3 AAC 23.840
3 AAC 23.850
3 AAC 26.010
3 AAC 26.020
3 AAC 26.030
3 AAC 26.040
3 AAC 26.050
3 AAC 26.060
3 AAC 26.070
3 AAC 26.075
3 AAC 26.080
3 AAC 26.090
3 AAC 26.100
3 AAC 26.110
3 AAC 26.300
3 AAC 28.700
3 AAC 28.705
3 AAC 28.725

References

AS 21.36.350
AS 21.36.910 Hearings and order on violation.
AS 23.30.155 Payment of compensation.

History

(Sec. 6 ch 163 SLA 1976; am Sec. 5, 6 ch 97 SLA 2000; am Sec. 3 ch 99 SLA 2000)