Utah Admin. Code R590-190-3 - Definitions
Terms used in this rule are defined in Section 31A-1-301. Additional terms are defined as follows:
(1) "Authorized
agent" means an individual, corporation, association, organization,
partnership, or other legal entity authorized to represent an insurer with
respect to a claim.
(2) "Claim
file" means a record either in its original form or as recorded by a process
that can accurately and reliably reproducer the original material regarding a
claim, its investigation, adjustment, and settlement.
(3)
(a)
"Claimant" means a first party claimant, a third party claimant, or
both.
(b) "Claimant" includes a
claimant's designated legal representative and an immediate family
member.
(4) "Day" means
calendar day.
(5) "Documentation"
means a physical or an electronic record related to a claim.
(6)
(a)
"First party claimant" means a person asserting a right to a benefit under a
policy to which the person is a party.
(b) "First party claimant" includes a
person's designated legal representative and an immediate family
member.
(7) "General
business practice" means a pattern of conduct in a business.
(8) "Investigation" means an activity by or
on behalf of an insurer related to determining a claim under a
policy.
(9) "Notice of loss" means
a claimant's notice that reasonably informs an insurer of facts related to a
claim.
(10) "Proof of loss" means
an insured's reasonable documentation in support of a claim.
(11) "Third party claimant" means a person
asserting a claim against an insured.
Notes
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