Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › UNFAIR PRACTICES › Standards Concerning Claims › Section 686A.675 - Standards applicable to all insurers

Current through June 11,
				2024
1. Within 30
				working days after receipt by the insurer of properly executed proofs of loss,
				the first-party claimant must be advised of the acceptance or denial of the
				claim by the insurer. No insurer may deny a claim on the grounds of a specific
				policy provision, condition or exclusion unless reference to that provision,
				condition or exclusion is included in the denial. The denial must be given to
				the claimant in writing and filed and retained in the insurer's claim file. If
				the claim of the first-party claimant is accepted, the insurer shall pay the
				claim within 30 days after it is accepted. If the accepted claim is not paid
				within that period, the insurer shall pay interest on the claim at the rate of
				interest established pursuant to
				NRS
				99.040. The interest must be calculated from
				the date on which the payment is due until the claim is paid.
2. If a claim is denied for reasons other
				than those described in subsection 1, and is made by any means other than
				writing, an appropriate notation must be made in the claim file of the
				insurer.
3. If the insurer needs
				more time to determine whether a claim of a first-party claimant should be
				accepted or denied, it must so notify the claimant within 30 working days after
				receipt of the proof of loss giving reasons that more time is needed. If the
				investigation remains incomplete, the insurer shall, 30 days after the date of
				the initial notification and every 30 days thereafter, send to the claimant a
				letter setting forth the reasons that additional time is needed for
				investigation.
4. Insurers may not
				fail to settle first-party claims on the basis that responsibility for payment
				should be assumed by others except as provided by policy provisions.
5. Insurers may not delay settlement of a
				claim directly with a claimant who is not an attorney or represented by an
				attorney by extending negotiations until the claimant's rights may be affected
				by a statute of limitations or a time limit which is part of an insurance
				contract or policy, without giving the claimant written notice that the time
				limit may be expiring and may affect the claimant's rights. Notice must be
				given 60 days before the date on which a time limit may expire.
6. No insurer may make statements which
				indicate that the rights of a third-party claimant may be impaired if a form or
				release is not completed within a given time, unless the statement is given for
				the purpose of notifying the third-party claimant of the provision of a statute
				of limitations.
7. Except for a
				claim involving health insurance, any case involving a claim in which there is
				a dispute over any portion of the insurance policy coverage, payment for the
				portion or portions not in dispute must be made notwithstanding the existence
				of the dispute where payment can be made without prejudice to any interested
				party.
Comm'r of Insurance,
				  M-9 § 8, eff. 2-21-80-NAC A by Div. of Insurance by R089-98,
				  9-25-98
NRS
					 679B.130,
					 686A.015,
					 686A.310