2008 Legislation
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HOUSE BILL NO. 520<br /> – Insurer, real property, claim pymts

HOUSE BILL NO. 520

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Bill Status



H0520...........................................................by BUSINESS
INSURANCE - Amends existing law relating to insurance trade practice and
fraud to provide additional duties of insurers of real property; to revise
unfair claims settlement practices; to revise penalties for unfair claims
settlement practices; and to provide for damages, unreasonable costs and
attorney's fees in the event of litigation.

02/12    House intro - 1st rdg - to printing
02/13    Rpt prt - to Bus

Bill Text




                                                                       
  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-ninth Legislature                   Second Regular Session - 2008

                                                                       

                              IN THE HOUSE OF REPRESENTATIVES

                                     HOUSE BILL NO. 520

                                   BY BUSINESS COMMITTEE

  1                                        AN ACT
  2    RELATING TO INSURANCE TRADE PRACTICE AND  FRAUDS;  AMENDING  SECTION  41-1328,
  3        IDAHO  CODE,  TO  PROVIDE  ADDITIONAL DUTIES OF INSURERS OF REAL PROPERTY;
  4        AMENDING SECTION 41-1329, IDAHO CODE, TO REVISE UNFAIR  CLAIMS  SETTLEMENT
  5        PRACTICES  AND  TO  MAKE  A  TECHNICAL  CORRECTION;  AND  AMENDING SECTION
  6        41-1329A, IDAHO CODE, TO REVISE PENALTIES  FOR  UNFAIR  CLAIMS  SETTLEMENT
  7        PRACTICES AND TO PROVIDE FOR DAMAGES, REASONABLE COSTS AND ATTORNEY'S FEES
  8        IN THE EVENT OF LITIGATION.

  9    Be It Enacted by the Legislature of the State of Idaho:

 10        SECTION  1.  That  Section 41-1328, Idaho Code, be, and the same is hereby
 11    amended to read as follows:

 12        41-1328.  PAYMENT OF CLAIMS BY INSURERS. (1) Every insurer issuing a motor
 13    vehicle insurance policy, as defined in  chapter  5,  title  41,  Idaho  Code,
 14    shall,  in the event of damage to a covered motor vehicle by collision and the
 15    election by the insurer to have such motor vehicle repaired, make  payment  by
 16    check  or  draft,  payable  to  the  repairer  or to the named insured and the
 17    repairer, jointly, no later than twenty (20) days subsequent to receipt of  an
 18    itemized bill or invoice covering repairs authorized by the insurer which have
 19    been satisfactorily completed.
 20        (2)  Every  insurer  of  real property as defined in section 41-504, Idaho
 21    Code, shall, in the event of damage to a covered property and  the  acceptance
 22    of coverage by the insurer, make payment by check or draft payable to: (a) the
 23    damage  repair prime contractor or other claims service provider designated by
 24    the policyholder or claimant to receive claims  disbursements;  or    (b)  the
 25    named  policyholder  and the damage repair prime contractor, jointly, no later
 26    than thirty (30) days  subsequent  to  receipt  of  the  damage  repair  prime
 27    contractor's  itemized invoice covering repairs which have been satisfactorily
 28    completed and accepted as attested by the policyholder.

 29        SECTION 2.  That Section 41-1329, Idaho Code, be, and the same  is  hereby
 30    amended to read as follows:

 31        41-1329.  UNFAIR CLAIMS SETTLEMENT PRACTICES. Pursuant to section 41-1302,
 32    Idaho  Code,  committing  or performing any of the following acts or omissions
 33    intentionally, or with such frequency as to indicate a general business  prac-
 34    tice  shall  be  deemed  to be an unfair method of competition or an unfair or
 35    deceptive act or practice in the business of insurance:
 36        (1)  Misrepresenting pertinent facts or insurance policy provisions relat-
 37    ing to coverages at issue including failing to provide to the claimant  within
 38    three  (3)  business days of the initial claim report a comprehensive explana-
 39    tion of coverage and services available under the policy contract  accompanied
 40    by  instructions  for  obtaining  all  benefits  available  under  the  policy
 41    contract;

                                       2

  1        (2)  Failing  to  acknowledge  and act reasonably promptly upon communica-
  2    tions with respect to claims arising under insurance policies;
  3        (3)  Failing to adopt and implement reasonable standards  for  the  prompt
  4    investigation of claims arising under insurance policies;
  5        (4)  Refusing  to pay claims without conducting a reasonable investigation
  6    based upon all available information;
  7        (5)  Failing to affirm or deny coverage of claims within a reasonable time
  8    after proof of loss statements have been completed;
  9        (6)  Not attempting in good faith to effectuate prompt, fair and equitable
 10    settlements of claims in which liability has become reasonably clear;
 11        (7)  Compelling insureds to institute litigation to  recover  amounts  due
 12    under  an  insurance  policy  by  offering substantially less than the amounts
 13    ultimately recovered in actions brought by such insureds;
 14        (8)  Attempting to settle a claim for less than the amount to which a rea-
 15    sonable man would have believed he was entitled by  reference  to  written  or
 16    printed advertising material accompanying or made part of an application;
 17        (9)  Attempting  to settle claims on the basis of an application which was
 18    altered without notice to, or knowledge or consent of the insured;
 19        (10) Making claims payments to insureds or beneficiaries  not  accompanied
 20    by  a  statement setting forth the coverage under which the payments are being
 21    made;
 22        (11) Making claims payments to a  policyholder or beneficiary after having
 23    been notified by the insurer of assignment of claims payment rights to a  dam-
 24    age repair service provider by the insured;
 25        (12) Making  known  to  insureds  or  claimants a policy of appealing from
 26    arbitration awards in favor of insureds or claimants for the purpose  of  com-
 27    pelling them to accept settlements or compromises less than the amount awarded
 28    in arbitration;
 29        (123) Delaying  the  investigation  or  payment  of claims by requiring an
 30    insured, claimant, or the physician of either to submit  a  preliminary  claim
 31    report  and  then  requiring the subsequent submission of formal proof of loss
 32    forms, both of which submissions contain substantially the same information;
 33        (134) Failing to promptly settle claims, where liability has  become  rea-
 34    sonably  clear, under one portion of the insurance policy coverage in order to
 35    influence settlements under other portions of the insurance  policy  coverage;
 36    or
 37        (145) Failing to promptly provide a reasonable explanation of the basis in
 38    the  insurance policy in relation to the facts or applicable law for denial of
 39    a claim or for the offer of a compromise settlement;
 40        (16) Failing to disclose and describe any  business  relationship  of  the
 41    insurer  with  providers  of  materials or services that are used in providing
 42    claim-related services;
 43        (17) Failing to credit to a policyholder's account or required  deductible
 44    expense  any  financial considerations received by the insurer pursuant to the
 45    policyholder's claim;
 46        (18) Failing to permit free and unfettered choice by the  policyholder  of
 47    any service provider or providers for property insurance claims;
 48        (19) Attempting  to  compel a policyholder's election of any damaged prop-
 49    erty service provider or providers  through  misrepresentation,  intimidation,
 50    compulsion,  or  by  any other means not specifically allowed by the insurance
 51    contract; or
 52        (20) Attempting to compel service providers to utilize  nonstandard  mate-
 53    rials  or  methods  or  to  circumvent requirements of federal, Idaho or local
 54    rules or regulations in performance of property claims services.

                                       3

  1        SECTION 3.  That Section 41-1329A, Idaho Code, be, and the same is  hereby
  2    amended to read as follows:

  3        41-1329A.  UNFAIR CLAIMS SETTLEMENT PRACTICES -- PENALTY. The director, if
  4    he  finds after a hearing, that an insurer has violated the provisions of sec-
  5    tion 41-1329, Idaho Code, may, in his  discretion,  impose  an  administrative
  6    penalty  not  to  exceed  the  greater of ten thousand dollars ($10,000) or an
  7    amount equal to three (3) times the combined amounts found to be in  violation
  8    to be deposited by the director as provided in section 41-406, Idaho Code, and
  9    may,  in  addition  to  the fine, or in the alternative to the fine, refuse to
 10    continue or suspend or revoke an insurer's certificate of  authority.  In  the
 11    event  of litigation relating to a property insurance contract, the prevailing
 12    party shall be entitled to damages as determined by the court plus  reasonable
 13    costs and attorney's fees.

Statement of Purpose / Fiscal Impact



                       STATEMENT OF PURPOSE

                           RS 17789 C1

This legislation provides amendments to Idaho State Code 41-1329
regarding insurer practices arising out of claims adjustment and
settlement practices that will assure compliance by insurers with
policy contract including disclosure of relevant business
relationships of the insurer while concurrently providing
enhanced competition in the provision of property damage repair
and rebuilding services through policyholder choice of service
provider. Amendments to 41-1328 will facilitate expedited project
completion times and contractor compensation. The small
businesses that provide property damage restoration services will
be able to more quickly reach agreement with claims managers on
scope and service prices. Amendments to 41-1328 increase the
penalties to insurers whose practices undermine the legislative
intent of the bill. 


                           FISCAL NOTE

There will be no fiscal impact to the general fund.  





Contact
Name: Representative Wendy Jaquet 
Phone: (208) 332-1130


STATEMENT OF PURPOSE/FISCAL NOTE                         H 520