North Carolina General Statutes 58-44-75. Definitions
As used in this Part:
(1) Administrator. – The Commissioner or the Commissioner’s designee; and the term is used interchangeably with regard to the Commissioner’s duties under this Part.
Terms Used In North Carolina General Statutes 58-44-75
- Fraud: Intentional deception resulting in injury to another.
(2) Repealed by Session Laws 2013-199, s. 22(e), effective June 26, 2013.
(3) Disputed claim. – Any matter on which there is a dispute as to the cause of loss or amount of loss, for which the insurer has denied payment, in part or whole, with respect to claims arising from a disaster. Unless the parties agree to mediate a disputed claim involving a lesser amount, a “disputed claim” involves the insured requesting one thousand five hundred dollars ($1,500) or more to settle the dispute, or the difference between the positions of the parties is one thousand five hundred dollars ($1,500) or more. “Disputed claim” does not include a dispute with respect to which the insurer has reported allegations of fraud, based on a referral to the insurer’s special investigative unit, to the Commissioner. A disputed claim does not include one in which there has been a denial of coverage for the loss because of exclusions in the policy, terms in the policy, conditions in the policy, or nonexistence of the policy at the time of the loss.
(4) Mediation. – As defined in N.C. Gen. Stat. § 7A-38.1(b)(2).
(5) Mediator. – A neutral person who acts to encourage and facilitate a resolution of a claim.
(6) Party or parties. – The insured and his or her insurer, including a surplus lines insurer and the underwriting associations in Articles 45 and 46 of this Chapter, when applicable. (2006-145, s. 1; 2012-12, s. 2(n); 2013-199, s. 22(e).)