(a)
(1) A health carrier shall pay a penalty of twelve percent (12%) per annum for late payment of claims under a health insurance contract pursuant to rules promulgated by the Insurance Commissioner, without necessity for demand for payment by a claimant.
(2) Hiring a third-party administrator or other person to process claims shall not relieve a health carrier of its obligation to pay this penalty.
(b) For purposes of this section:
(1) “Claimant” means a person insured or covered by a health carrier, a provider holding a valid assignment from a person insured or covered by a health carrier, or a provider contracted with a health carrier, who is claiming a benefit under a health insurance contract;
(2)
(A) “Health carrier” means a health maintenance organization, hospital medical service corporation, or a disability insurance company.
(B) “Health carrier” includes a self-insured governmental or church plan and third-party administrators that administer or adjust disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan.
(C) “Health carrier” does not include:
(i) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or
(ii) Any person, company, or organization licensed or registered to issue or who issues any insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 — 23-62-107 providing medical or hospital benefits for accidental injury or disability; and
(3)
(A) “Health insurance contract” means a disability insurance policy, a hospital medical service corporation contract, a health maintenance organization contract, or a plan document issued or provided by a health carrier.
(B) “Health insurance contract” does not include a disability income insurance policy, a long-term care contract, a hospital indemnity contract, an accident-only contract, or any other form of disability insurance policy that provides a benefit as a result of a sickness or accident that does not directly cover expenses related to health care treatment.
Structure Arkansas Code
Title 23 - Public Utilities and Regulated Industries
Subchapter 2 - Trade Practices Act
§ 23-66-204. Provisions of subchapter additional to existing law
§ 23-66-205. Unfair competition or unfair or deceptive acts or practices prohibited
§ 23-66-206. Unfair methods of competition and unfair or deceptive acts or practices defined
§ 23-66-207. Rules to identify prohibited methods of competition, acts, or practices
§ 23-66-208. Power of commissioner to examine and investigate
§ 23-66-209. Hearings — Procedures
§ 23-66-210. Cease and desist and penalty orders — Modifications
§ 23-66-211. Penalty for violation of cease and desist orders
§ 23-66-212. Judicial review of cease and desist orders
§ 23-66-213. Judicial review by intervenor
§ 23-66-215. Penalty for late payment of claims by health carriers