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Terms Used In Utah Code 31A-21-313

  • Accident and health insurance: means insurance to provide protection against economic losses resulting from:
              (1)(a)(i) a medical condition including:
                   (1)(a)(i)(A) a medical care expense; or
                   (1)(a)(i)(B) the risk of disability;
              (1)(a)(ii) accident; or
              (1)(a)(iii) sickness. See Utah Code 31A-1-301
  • Appraisal: A determination of property value.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • health insurance: means insurance providing:
              (84)(a)(i) a health care benefit; or
              (84)(a)(ii) payment of an incurred health care expense. See Utah Code 31A-1-301
  • Insurance: includes :
              (96)(b)(i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
              (96)(b)(ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
              (96)(b)(iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
  • Person: includes :
         (146)(a) an individual;
         (146)(b) a partnership;
         (146)(c) a corporation;
         (146)(d) an incorporated or unincorporated association;
         (146)(e) a joint stock company;
         (146)(f) a trust;
         (146)(g) a limited liability company;
         (146)(h) a reciprocal;
         (146)(i) a syndicate; or
         (146)(j) another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301
  • Policy: includes a service contract issued by:
              (150)(b)(i) a motor club under Chapter 11, Motor Clubs;
              (150)(b)(ii) a service contract provided under Chapter 6a, Service Contracts; and
              (150)(b)(iii) a corporation licensed under:
                   (150)(b)(iii)(A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
                   (150)(b)(iii)(B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301
  • Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5
  • Statute: A law passed by a legislature.
     (1)(a) A person shall commence an action on a written policy or contract of first party insurance within three years after the inception of the loss except as provided in:

          (1)(a)(i) Subsection 31A-22-305(11); and
          (1)(a)(ii) Subsection 31A-22-307(7).
     (1)(b) The inception of the loss on a fidelity bond is the date the insurer first denies all or part of a claim made under the fidelity bond.
(2) Except as provided in Subsection (1) or elsewhere in this title, an action on a written policy or contract for insurance is subject to the law applicable to limitation of actions in Title 78B, Chapter 2, Statutes of Limitations.
(3) An insurance policy may not:

     (3)(a) limit the time for beginning an action on the policy to a time less than that authorized by statute;
     (3)(b) prescribe in what court an action may be brought on the policy; or
     (3)(c) provide that no action may be brought, subject to permissible arbitration provisions in contracts.
(4)

     (4)(a) Unless by verified complaint it is alleged that prejudice to the complainant will arise from a delay in bringing suit against an insurer, which prejudice is other than the delay itself, an action may not be brought against an insurer on an insurance policy to compel payment under the insurance policy until the earlier of:

          (4)(a)(i) 60 days after proof of loss has been furnished as required under the policy;
          (4)(a)(ii) waiver by the insurer of proof of loss; or
          (4)(a)(iii)

               (4)(a)(iii)(A) the insurer’s denial of full payment; or
               (4)(a)(iii)(B) for an accident and health insurance policy, the insurer’s denial of payment.
     (4)(b) Under an accident and health insurance policy, an insurer may not require the completion of an appeals process that exceeds the provisions in 29 C.F.R. § 2560.503-1 to bring suit under this Subsection (4).
(5) The period of limitation is tolled during the period in which the parties conduct an appraisal or arbitration procedure prescribed by the insurance policy, by law, or as agreed to by the parties.