Mississippi Administrative Code › Title 1 - Secretary of State › Part 12 - Regulation and Enforcement - Preneed Funeral Service and Mdse. and Perpetual Care Cemeteries Regulation › Subpart 3 - Mississippi Preneed Contracts Loss Recovery Association Rules › Chapter 5 - Claims Administration › Rule 1-12-3-5.2 - Procedures for Processing Claims

Current through June 25, 2024
Upon receipt of a properly completed claim form, the
					 Secretary of State's Office will notify the Association Directors. The
					 Secretary of State's Office and the Association Directors will then set up a
					 meeting within a reasonable amount of time at which at least a quorum of the
					 Association Directors are available to be present either in person or via
					 telephone or internet conferencing. At said meeting, the Association Directors
					 will consider the Claim (or Claims) and decide by majority vote to approve the
					 claim for payment, reject the claim, or direct the staff of the Secretary of
					 State's Office to collect additional information in order to dispose of the
					 claim. When a decision has been made, the Association will notify the claimant
					 of the decision via Certified Mail, Return Receipt Requested. If the Claimant
					 disagrees with the decision, he or she may request a reconsideration of the
					 decision within ten (10) days of receipt of the same. A Claimant has only one
					 opportunity to request reconsideration; any additional information the Claimant
					 feels should be considered should be submitted along with the reconsideration
					 request.
The Association shall:
A. Determine the appropriate loss payee
				  entitled to receive compensation/reimbursement from the Fund;
B. Determine the amount of the
				  claim;
C. Provide opportunity for
				  objections to be raised by any Claimant with regard to the decision for each
				  claim;
D. Approve a final
				  determination for each claim;
E.
				  Issue requests for payments from the Fund; and
F. Reject claims, provided that, if the
				  Association rejects a claim, it promptly notifies the claimant in writing
				  setting forth the reasons for the rejection.
The Association is responsible for investigating all
					 applications and may reject, deny, or approve claims in whole or in part.
					 Payment may only be made to the extent that money is available in the Fund and
					 payments may be prorated among applicants. The Association has complete
					 discretion to determine the order, amount, and manner of payment of approved
					 claims and may approve a book of business as a single claim.
The Association may approve a claim, in whole or in part,
					 that includes more than one claim for the benefit or purchasers of prepaid
					 contracts of an insolvent provider as part of a plan to arrange for another
					 provider to assume the obligations of the provider being liquidated if the
					 Association finds that the plan is reasonable and in the best interests of the
					 contract beneficiaries.
No third-party beneficiary has a right in the Fund. No
					 claimant is eligible for compensation from the Fund unless the contract
					 purchaser paid the loss recovery fee to the Association when the preneed
					 contract was purchased.
Reimbursement from the Fund must not exceed the total
					 payment made by the customer for preneed funeral or cemetery services and
					 merchandise required to be trusted by Miss Code Ann. §
											75-63-59.
					 No current or future insurance benefits may be reimbursed.
The Association shall have wide discretion to determine the
					 appropriate loss payee. Approved loss payees may include the purchaser of the
					 preneed contract, the decedent's estate, the substitute provider, or the
					 individual(s) signing as responsible party for at-need funeral or cemetery
					 services and merchandise. In some instances, joint payment loss payees may be
					 appropriate.
All funds received by the Association shall be held in a
					 separate account maintained by the State Treasurer to be used exclusively by
					 the Association. Warrants from the Fund may only be issued by the Department of
					 Finance and Administration following a request by a majority vote of
					 Association Directors. All interest or other income earned on the fund shall be
					 retained by the fund.
Miss. Code Ann.
					 §
											75-63-81(9)(Rev.
					 2009).