§ 27-303. Unfair claim settlement practices -- In general

   It is an unfair claim settlement practice and a violation of this subtitle for an insurer or nonprofit health service plan to:

   (1) misrepresent pertinent facts or policy provisions that relate to the claim or coverage at issue;

   (2) refuse to pay a claim for an arbitrary or capricious reason based on all available information;

   (3) attempt to settle a claim based on an application that is altered without notice to, or the knowledge or consent of, the insured;

   (4) fail to include with each claim paid to an insured or beneficiary a statement of the coverage under which payment is being made;

   (5) fail to settle a claim promptly whenever liability is reasonably clear under one part of a policy, in order to influence settlements under other parts of the policy;

   (6) fail to provide promptly on request a reasonable explanation of the basis for a denial of a claim;

   (7) fail to meet the requirements of Title 15, Subtitle 10B of this article for preauthorization for a health care service;

   (8) fail to comply with the provisions of Title 15, Subtitle 10A of this article;

   (9) fail to act in good faith, as defined under § 27-1001 of this title, in settling a first-party claim under a policy of property and casualty insurance; or

   (10) fail to comply with the provisions of § 16-118 of this article.

HISTORY: An. Code 1957, art. 48A, § 230A; 1997, ch. 35, § 2; 1998, ch. 111, § 2; ch. 112, § 2; ch. 755; 2007, ch. 150; 2012, ch. 171.