514G.108 Prompt payment of claims — requirements.
1. An insurer providing long-term care insurance under this chapter and subject to state insurance regulation shall either accept and pay or deny a clean claim. For the purposes of this section, “clean claim” means a properly completed paper or electronic request for payment that contains all necessary information for the insurer to timely adjudicate and pay claims for long-term care benefits under the policy, does not involve coordination of benefits for third-party liability or subrogation, and does not involve the existence of particular circumstances requiring special treatment that prevents a prompt payment from being made.
2. The commissioner shall adopt rules establishing processes for timely adjudication and payment of claims for long-term care benefits by insurers.
3. Payment of a clean claim shall include interest at the rate of ten percent per annum when an insurer or other entity that administers or processes claims on behalf of the insurer fails to timely pay a clean claim.
2008 Acts, ch 1175, §9
Structure Iowa Code
Chapter 514G - LONG-TERM CARE INSURANCE ACT
Section 514G.10 - Long-term care consumer guide.
Section 514G.101 - Title and purpose.
Section 514G.103 - Definitions.
Section 514G.104 - Extraterritorial jurisdiction — group long-term care insurance.
Section 514G.105 - Disclosure and performance standards for long-term care insurance.
Section 514G.106 - Incontestability period.
Section 514G.107 - Nonforfeiture benefits.
Section 514G.108 - Prompt payment of claims — requirements.
Section 514G.109 - Benefit trigger determinations — notice — appeals.
Section 514G.110 - Independent review of benefit trigger determinations.
Section 514G.111 - Authority to promulgate rules.