(1) The director shall enforce the provisions of this chapter and shall review and, if appropriate, investigate complaints received by the department related to noncompliance with the provisions of this chapter.
(2)  If the director determines an insurer has violated the provisions of this chapter, the director may impose an administrative fine not to exceed five thousand dollars ($5,000) based upon an enforcement action.
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Terms Used In Idaho Code 41-5606

  • Department: means the department of insurance. See Idaho Code 41-5601
  • Director: means the director of the department of insurance. See Idaho Code 41-5601
  • Insurer: means any insurer that sells hospital, medical, long-term care, or vision insurance policies or certificates and managed care organizations. See Idaho Code 41-5601
  • Practitioner or facility: means any physician, hospital or other person or facility licensed or otherwise authorized to furnish health care services. See Idaho Code 41-5601
(3)  The director shall not suspend or revoke an insurer’s certificate of authority for violation of this chapter.
(4)  No administrative penalty shall be imposed against an insurer under this chapter or any other provision of law for failure to comply with this chapter if, in the calendar year it has paid ninety-five percent (95%) or more of all claims subject to this chapter to or on behalf of beneficiaries within the time periods set forth in section 41-5602, Idaho Code.
(5)  This section shall not create a private cause of action by or on behalf of a beneficiary or practitioner or facility against an insurer.