Ala. Admin. Code r. 482-1-125-.05 - Misrepresentation Of Policy Provisions

(1) No insurer shall deny a claim based on a first party claimant's failure to exhibit the damaged property without the proof of demand and of an unfounded refusal by the first party claimant to do so and unless the insurer has documented breach of relevant policy provisions in the claims file.

(2) No insurer shall deny a claim based upon the failure of a first party claimant to give proper written notice of loss within a specified time limit unless the denial is based upon a specific policy provision or the first party claimant's failure to give notice constitutes a breach of the first party claimant's policy.

(3) No insurer shall indicate to a first party claimant on a payment draft, check or in any accompanying letter that said payment is "final" or "a release" of any claim unless the policy limit has been paid or there has been a compromise settlement agreed to by the first party claimant and the insurer as to coverage and amount payable under the policy.

(4) No insurer shall issue checks or drafts in partial settlement of a loss or claim under a specific coverage that contains language purporting to release the insurer or its insured from total liability.

Author: Commissioner of Insurance

Notes

Ala. Admin. Code r. 482-1-125-.05

New Rule: May 27, 2003; effective June 9, 2003. Filed with LRS May 30, 2003. Rule is not subject to the Alabama Administrative Procedure Act.

Statutory Authority: Code of Ala. 1975, §§ 27-2-17, 27-1-17, 27-1-19, 27-12-21, 27-12-24, 27-14-8, 27-14-11, 27-14-9.