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<section article="gin" article_name="Insurance" number="27-304" title_number="27" title_name="Unfair Trade Practices and Other Prohibited Practices" subtitle_number="3" subtitle_name="Unfair Claim Settlement Practices">
  <text>It is an unfair claim settlement practice and a violation of this subtitle for an insurer, nonprofit health service plan, or health maintenance organization, when committed with the frequency to indicate a general business practice, to:</text>
  <level label="1">
    <text>misrepresent pertinent facts or policy provisions that relate to the claim or coverage at issue;</text>
  </level>
  <level label="2">
    <text>fail to acknowledge and act with reasonable promptness on communications about claims that arise under policies;</text>
  </level>
  <level label="3">
    <text>fail to adopt and implement reasonable standards for the prompt investigation of claims that arise under policies;</text>
  </level>
  <level label="4">
    <text>refuse to pay a claim without conducting a reasonable investigation based on all available information;</text>
  </level>
  <level label="5">
    <text>fail to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed;</text>
  </level>
  <level label="6">
    <text>fail to make a prompt, fair, and equitable good faith attempt, to settle claims for which liability has become reasonably clear;</text>
  </level>
  <level label="7">
    <text>compel insureds to institute litigation to recover amounts due under policies by offering substantially less than the amounts ultimately recovered in actions brought by the insureds;</text>
  </level>
  <level label="8">
    <text>attempt to settle a claim for less than the amount to which a reasonable person would expect to be entitled after studying written or printed advertising material accompanying, or made part of, an application;</text>
  </level>
  <level label="9">
    <text>attempt to settle a claim based on an application that is altered without notice to, or the knowledge or consent of, the insured;</text>
  </level>
  <level label="10">
    <text>fail to include with each claim paid to an insured or beneficiary a statement of the coverage under which the payment is being made;</text>
  </level>
  <level label="11">
    <text>make known to insureds or claimants a policy of appealing from arbitration awards in order to compel insureds or claimants to accept a settlement or compromise less than the amount awarded in arbitration;</text>
  </level>
  <level label="12">
    <text>delay an investigation or payment of a claim by requiring a claimant or a claimant’s licensed health care provider to submit a preliminary claim report and subsequently to submit formal proof of loss forms that contain substantially the same information;</text>
  </level>
  <level label="13">
    <text>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;</text>
  </level>
  <level label="14">
    <text>fail to provide promptly a reasonable explanation of the basis for denial of a claim or the offer of a compromise settlement;</text>
  </level>
  <level label="15">
    <text>refuse to pay a claim for an arbitrary or capricious reason based on all available information;</text>
  </level>
  <level label="16">
    <text>fail to meet the requirements of Title 15, Subtitle 10B of this article for preauthorization for a health care service;</text>
  </level>
  <level label="17">
    <text>fail to comply with the provisions of Title 15, Subtitle 10A of this article; or</text>
  </level>
  <level label="18">
    <text>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.</text>
  </level>
</section>
