NAIC Unfair Claims Settlement Practices Model Act (MDL-900) and Model Regulation (MDL-902) mdl900-s4-b-c-f-g-acknowledge-standards-investigate: Acknowledge communications promptly, adopt standards for prompt investigation and settlement, investigate before refusing, and affirm or deny coverage within a reasonable time

What does mdl900-s4-b-c-f-g-acknowledge-standards-investigate require?

Items B, C, F and G address the mechanics of handling: failing to acknowledge pertinent communications about claims with reasonable promptness; having no reasonable, implemented standards for investigating and settling claims promptly; refusing to pay claims without a reasonable investigation; and failing to affirm or deny coverage within a reasonable time after the investigation is complete. The insurer's written claim standards, with time limits for acknowledgement, investigation steps and coverage decisions, are the evidence that the standards exist, and file dates are the evidence that they are followed.