Montana Code 33-18-201. Unfair claim settlement practices prohibited
33-18-201. Unfair claim settlement practices prohibited. A person may not, with such frequency as to indicate a general business practice, do any of the following:
Terms Used In Montana Code 33-18-201
- Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
- Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
- Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
(1)misrepresent pertinent facts or insurance policy provisions relating to coverages at issue;
(2)fail to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies;
(3)fail to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies;
(4)refuse to pay claims without conducting a reasonable investigation based upon all available information;
(5)fail to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed;
(6)neglect to attempt in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear;
(7)compel insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by the insureds;
(8)attempt to settle a claim for less than the amount to which a reasonable person would have believed the person was entitled by reference to written or printed advertising material accompanying or made part of an application;
(9)attempt to settle claims on the basis of an application that was altered without notice to or knowledge or consent of the insured;
(10)make claims payments to insureds or beneficiaries not accompanied by statements setting forth the coverage under which the payments are being made;
(11)make known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration;
(12)delay the investigation or payment of claims by requiring an insured, claimant, or physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information;
(13)fail to promptly settle claims, if liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage; or
(14)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.