reglab/housing_qa huggingface dataset:
UT Code § 31A-26-301.7 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 301.7 - Dental claim transparency.

 Effective 5/5/2021  31A-26-301.7. Dental claim transparency.    (1) As used in this section:   (a) "Bundling" means the practice of combining distinct dental procedures into one procedure for billing purposes.     (b) "Dental plan" means the same as that term is defined in Section 31A-22-646.     (c) "Downcoding" means the adjustment of a claim submitted to a dental plan to a less complex or lower cost procedure code.     (d) "Covered services" means the same as that term is defined in Section 31A-22-646.     (e) "Material change" means a change to:   (i) a dental plan's rules, guidelines, policies, or procedures concerning payment for dental services;     (ii) the general policies of the dental plan that affect a reimbursement paid to providers; or     (iii) the manner by which a dental plan adjudicates and pays a claim for services.         (2) An insurer that contracts or renews a contract with a dental provider shall:   (a) make a copy of the insurer's current dental plan policies available online; and     (b) if requested by a provider, send a copy of the policies to the provider through mail or electronic mail.       (3) Dental policies described in Subsection (2) shall include:   (a) a summary of all material changes made to a dental plan since the policies were last updated;     (b) the downcoding and bundling policies that the insurer reasonably expects to be applied to the dental provider or provider's services as a matter of policy; and     (c) a description of the dental plan's utilization review procedures, including:   (i) a procedure for an enrollee of the dental plan to obtain review of an adverse determination in accordance with Section 31A-22-629; and     (ii) a statement of a provider's rights and responsibilities regarding the procedures described in Subsection (3)(c)(i).         (4) An insurer may not maintain a dental plan that:   (a) based on the provider's contracted fee for covered services, uses downcoding in a manner that prevents a dental provider from collecting the fee for the actual service performed from either the plan or the patient; or     (b) uses bundling in a manner where a procedure code is labeled as nonbillable to the patient unless, under generally accepted practice standards, the procedure code is for a procedure that may be provided in conjunction with another procedure.       (5) An insurer shall ensure that an explanation of benefits for a dental plan includes the reason for any downcoding or bundling result.    Enacted by Chapter 288, 2021 General Session
UT Code § 31A-26-302 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 302 - Settlement of claims in credit life and accident and health insurance.

31A-26-302. Settlement of claims in credit life and accident and health insurance.    (1) The creditor shall promptly report all claims to the insurer or its designated claim representative. The insurer shall maintain adequate claims files. All claims shall be settled as soon as possible in accordance with the terms of the insurance contract.     (2) The insurer shall pay all claims either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of that claimant to another.     (3) A person other than the insurer or its designated claim representative may not settle or adjust claims. The creditor may not be designated as a claims representative.    Amended by Chapter 116, 2001 General Session
UT Code § 31A-26-304 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 304 - Prohibition of conflicting roles.

31A-26-304. Prohibition of conflicting roles.  A person licensed concurrently as both an independent and a public adjuster may not represent both the insurer and the insured in the same transaction.  Enacted by Chapter 242, 1985 General Session
UT Code § 31A-26-305 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 305 - Request for accepted check.

31A-26-305. Request for accepted check.  If an insurance policy claimant entitled to receive money in settlement of a claim makes a timely request to the insurer for payment by accepted check, the insurer shall make payment to the claimant with a check accepted by the drawee under Sections 70A-3-410 through 70A-3-413.  Amended by Chapter 204, 1986 General Session
UT Code § 31A-26-306 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 306 - Place of business -- Records.

31A-26-306. Place of business -- Records.    (1)   (a) An insurance adjuster licensed under this chapter shall register and maintain with the commissioner:   (i) the address and telephone number of the licensee's principal place of business;     (ii) a valid business email address at which the commissioner may contact the licensee; and     (iii) if the licensee is an individual, the licensee's residence address and telephone number.       (b) A licensee shall notify the commissioner within 30 days of a change in one of the following required to be registered under Subsection (1)(a):   (i) an address;     (ii) a telephone number; or     (iii) a business email address.         (2) Except as provided under Subsection (3), an insurance adjuster shall keep at the address registered under Subsection (1), a record of the transactions consummated under the insurance adjuster's license, including a record of:   (a) each investigation or adjustment undertaken or consummated; and     (b) a fee, commission, or other compensation received or to be received by the adjuster on account of the investigation or adjustment.       (3) Subsection (2) is satisfied if the records specified in Subsection (2) can be obtained immediately from a central storage place elsewhere by on-line computer terminals located at the registered address.     (4)   (a) A record maintained as to a transaction under Subsection (2) shall be kept available for the inspection of the commissioner during all business hours for a period of time after the date of the transaction specified by the commissioner by rule, but in no case for less than the current calendar year plus three years.     (b) Discarding a record after the then applicable record retention period is passed does not place the licensee in violation of a later-adopted longer record retention period.      Amended by Chapter 284, 2011 General Session
UT Code § 31A-26-307 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 307 - Claim reports to commissioner.

31A-26-307. Claim reports to commissioner.  On the commissioner's request, any insurer or licensed adjuster connected with a loss or claim shall report to the commissioner all facts relative to the loss or claim arising under any insurance contract covering a subject of insurance that is resident, located, or to be performed in this state.  Enacted by Chapter 242, 1985 General Session
UT Code § 31A-26-308 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 308 - Settlement of liability insurance claim not admission of liability.

31A-26-308. Settlement of liability insurance claim not admission of liability.  No settlement or partial settlement of a claim against any insured under a liability insurance policy is an admission, by either the insured or the insurer, of the liability of the insured on any claim arising from the same event or set of facts, whether the settlement is made by the insured, the insurer, or any other person on behalf of the insured or the insurer.  Enacted by Chapter 242, 1985 General Session
UT Code § 31A-26-309 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 309 - Adjuster's duty to report illegal insurance.

31A-26-309. Adjuster's duty to report illegal insurance.  Section 31A-15-110 applies to the adjuster's duty to report illegal insurance.  Enacted by Chapter 242, 1985 General Session
UT Code § 31A-26-310 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 310 - Compensation of insurer's or insured's claims adjuster.

31A-26-310. Compensation of insurer's or insured's claims adjuster.    (1)   (a) Except as provided in Subsection (2), an insurer or an insured may not pay a person who is representing the insurer or insured in connection with an insurance claim adjustment on any basis that is dependent, in whole or in part, upon the amounts paid an insured or claimant under an insurance policy.     (b) Subsection (1)(a) includes payments to:   (i) an employee of:   (A) the insurer; or     (B) the insured;       (ii) an independent contractor; or     (iii) a public adjuster.         (2) Subsection (1) does not prohibit a compensation arrangement:   (a) based upon the overall profitability of the insurer;     (b) based upon the discovery or proof of fraudulent insurance claims; or     (c) conforming to an order or rule of the commissioner that addresses the compensation of persons engaged in insurance adjusting on behalf of:   (i) an insurer; or     (ii) an insured.        Amended by Chapter 252, 2003 General Session
UT Code § 31A-26-311 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 311 - Rescission of contracts with public adjusters.

31A-26-311. Rescission of contracts with public adjusters.    (1) Except as provided in Subsection (2), an insured or claimant under an insurance policy who contracts with a public adjuster to assist in the settlement of a claim may rescind that contract by delivering written notice of rescission to the public adjuster within 10 days of entering into the contract.     (2) Subsection (1) does not apply if prior to the rescission the public adjuster has effected an acceptable settlement of the claim.    Enacted by Chapter 204, 1986 General Session
UT Code § 31A-26-312 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 3 - Claim Practices|Section 312 - Prohibited conduct.

 Effective 5/9/2017  31A-26-312. Prohibited conduct.    (1) An independent adjuster or public adjuster may not:   (a) participate directly or indirectly in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the independent adjuster or public adjuster;     (b) engage in any other activities that may reasonably be construed as presenting a conflict of interest, including soliciting or accepting remuneration from, or having a financial interest in, or deriving any direct or indirect financial benefit from, a salvage firm, repair firm, construction firm, or other firm that obtains business in connection with a claim that the independent adjuster or public adjuster has a contract or agreement to adjust;     (c) subject to Subsection (2), directly or indirectly solicit employment for an attorney or enter into a contract with an insured for the primary purpose of referring an insured to an attorney and without actually performing the services customarily provided by an independent adjuster or public adjuster;     (d) act on behalf of an attorney in having an insured sign an attorney representation agreement; or     (e) accept a fee, commission, or other valuable consideration of any nature, regardless of form or amount, in exchange for the referral by an independent adjuster or public adjuster of an insured to a third-party person, including an attorney, appraiser, umpire, construction company, contractor, repair firm, or salvage company.       (2) Subsection (1)(c) may not be construed to prohibit an independent adjuster or public adjuster from recommending a specific attorney to an insured.     (3) An independent adjuster or public adjuster who violates this section is subject to Section 31A-2-308.    Enacted by Chapter 168, 2017 General Session
UT Code § 31A-26-401 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 4 - Public Adjusters|Section 401 - Required contracts.

 Effective 5/9/2017  31A-26-401. Required contracts.    (1) A public adjuster may not, directly or indirectly, act within this state as a public adjuster without having first entered into a contract, in writing, on a form filed with the department in accordance with Section 31A-21-201, executed in duplicate by the public adjuster and the insured or the insured's duly authorized representative. A public adjuster may not use a form of contract that is not filed with the department.     (2) A contract described in Subsection (1) is subject to recision in accordance with Section 31A-26-311.     (3)   (a) A contract described in Subsection (1) shall include a prominently displayed notice in 12-point boldface type that states "WE REPRESENT THE INSURED ONLY."     (b) The commissioner by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, may require additional prominently displayed notice requirements in the contract as the commissioner considers necessary.       (4) A public adjuster shall keep at the public adjuster's principal place of business a copy of each contract entered into in this state for the current year plus three years, and each contract shall be available at all times for inspection, without notice, by the commissioner or the commissioner's authorized representative.     (5) A public adjuster may not enter into a contract with an insured and collect compensation as provided in the contract without actually performing the services customarily provided by a licensed public adjuster for the insured.    Enacted by Chapter 168, 2017 General Session
UT Code § 31A-26-402 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 4 - Public Adjusters|Section 402 - Compensation.

 Effective 5/9/2017  31A-26-402. Compensation.    (1) Except as provided by Subsection (2), a public adjuster may receive compensation for service provided under this chapter consisting of an hourly fee, a flat rate, a percentage of the total amount paid by an insurer to resolve a claim, or another method of compensation.     (2)   (a) A public adjuster may not receive a compensation consisting of a percentage of the total amount paid by an insurer to resolve a claim on a claim on which the insurer, not later than 72 hours after the date on which the loss is reported to the insurer, either pays or commits in writing to pay to the insured the policy limit of the insurance policy.     (b) A public adjuster is entitled to reasonable compensation from the insured for services provided by the public adjuster on behalf of the insured, based on the time spent on a claim that is subject to this Subsection (2) and expenses incurred by the public adjuster, until the claim is paid or the insured receives a written commitment to pay from the insurer.       (3) Except for the payment of compensation by the insured, a person paying proceeds of a policy of insurance or making a payment affecting an insured's rights under a policy of insurance shall:   (a) include the insured as a payee on the payment draft or check; and     (b) require the written signature and endorsement of the insured on the payment draft or check.       (4) A public adjuster may not accept any payment that violates this section notwithstanding whether the insured gives authorization to the public adjuster. A public adjuster may not sign and endorse any payment draft or check on behalf of an insured.    Enacted by Chapter 168, 2017 General Session
UT Code § 31A-26-403 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 26 - Insurance Adjusters|Part 4 - Public Adjusters|Section 403 - Rulemaking.

 Effective 5/9/2017  31A-26-403. Rulemaking.  The commissioner may make rules, in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:  (1) addressing the forms required by this part;     (2) providing for notice requirements in contracts; and     (3) establishing the scope of a contract a public adjuster enters into with an insured that the public adjuster represents.    Enacted by Chapter 168, 2017 General Session
UT Code § 31A-27-501 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 27 - Delinquency Administrative Action Provisions|Part 5 - Administrative Actions|Section 501 - Title -- Construction -- Commissioner's powers.

31A-27-501. Title -- Construction -- Commissioner's powers.    (1) This chapter is known as the "Delinquency Administrative Action Provisions."     (2) The proceedings authorized by this part may be applied to:   (a) all insurers and reinsurers:   (i) who are doing, or have done, an insurance business in this state; and     (ii) against whom claims arising from that business may exist;       (b) all insurers who have the appearance of or claim they do an insurance business in this state;     (c) all insurers who have insureds resident in this state; and     (d) all other persons organized or in the process of organizing to do an insurance business as an insurer in this state.       (3) This part shall be liberally construed to protect the interests of insureds, creditors, and the public generally, with minimum interference with the normal prerogatives of owners, through:   (a) early detection of any potentially dangerous condition in an insurer;     (b) prompt application of appropriate regulatory corrective measures; and     (c) regulation of the insurance business by law relating to insolvency of insurers and by substantive rules on the entire insurance business.       (4) This part does not limit the powers granted the commissioner by other provisions of law.    Renumbered and Amended by Chapter 309, 2007 General Session
UT Code § 31A-27-502 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 27 - Delinquency Administrative Action Provisions|Part 5 - Administrative Actions|Section 502 - Definitions.

31A-27-502. Definitions.  As used in this part, "record" is as defined in Section 31A-27a-102.  Enacted by Chapter 309, 2007 General Session
UT Code § 31A-27-504 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 27 - Delinquency Administrative Action Provisions|Part 5 - Administrative Actions|Section 504 - Conduct of hearings.

31A-27-504. Conduct of hearings.    (1) The commissioner shall hold a hearing conducted under Section 31A-27-503 privately unless the insurer requests a public hearing.     (2) All records of the insurer, other documents, and all department files and papers, so far as they pertain to or are a part of the record of a hearing conducted under Section 31A-27-503, shall be kept confidential:   (a) except as is necessary to obtain compliance with a hearing conducted under Section 31A-27-503; or     (b) unless the insurer requests that the matter be made public.        (3) Any person having possession or custody of and refusing to deliver any of the records of an insurer against which an order is issued by the commissioner is in accordance with a hearing conducted under Section 31A-27-503 subject to Section 31A-2-308.    Renumbered and Amended by Chapter 309, 2007 General Session
UT Code § 31A-27a-101 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 27a - Insurer Receivership Act|Part 1 - General Provisions|Section 101 - Title -- Construction -- Commissioner's powers.

31A-27a-101. Title -- Construction -- Commissioner's powers.    (1) This chapter is known as the "Insurer Receivership Act."     (2) The proceedings authorized by this chapter may be applied to:   (a) all insurers and reinsurers:   (i) who are doing, or have done, an insurance business in this state; and     (ii) against whom claims arising from that business may exist;       (b) all insurers who have the appearance of or claim they do an insurance business in this state;     (c) all insurers who have insureds resident in this state; and     (d) all other persons organized or in the process of organizing to do an insurance business as an insurer in this state.       (3) This chapter shall be liberally construed to protect the interests of insureds, claimants, creditors, and the public generally through:   (a) early detection of any potentially hazardous condition in an insurer;     (b) prompt application of appropriate corrective measures;     (c) the commissioner making rules pertaining to Subsections (3)(a) and (b):   (i) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and     (ii) that are similar to those set forth in the Model Regulation to Define Standards and Commissioner's Authority for Companies Deemed to be in Hazardous Financial Condition of the National Association of Insurance Commissioners;       (d) improved methods for conserving and rehabilitating insurers;     (e) enhanced efficiency and economy of liquidation, through clarification of the law, to minimize legal uncertainty and litigation;     (f) apportionment of any unavoidable loss in accordance with the statutory priorities set out in this chapter;     (g) lessening the problems of interstate receivership by:   (i) facilitating cooperation among states in delinquency proceedings; and     (ii) extending the scope of personal jurisdiction over debtors of the insurer outside this state;       (h) regulation of the business of insurance by the impact of the law relating to delinquency procedures and by substantive rules; and     (i) providing for a comprehensive scheme for the receivership of insurance companies and those subject to this chapter as part of the regulation of the business of insurance in this state.       (4) A proceeding in the case of insurer insolvency and delinquency are integral aspects of the business of insurance and are of vital public interest and concern.     (5) This chapter does not limit the powers granted the commissioner by other provisions of law.     (6) The powers and authority of a receiver under this chapter are:   (a) cumulative; and     (b) in addition to any power or authority available to a receiver under a law other than this chapter.      Amended by Chapter 253, 2012 General Session
UT Code § 31A-27a-103 (2021)
2021 Utah Code|Title 31A - Insurance Code|Chapter 27a - Insurer Receivership Act|Part 1 - General Provisions|Section 103 - Insurer receivership laws.

31A-27a-103. Insurer receivership laws.    (1) The state's insurer receivership laws consists of:   (a) this chapter; and     (b)Chapter 28, Guaranty Associations.       (2) The laws listed in Subsection (1) shall be construed together in a manner that is consistent.    Enacted by Chapter 309, 2007 General Session