1. Except as otherwise provided in this section, an insurer shall pay or deny a bill for accident benefits received from a provider of health care within 45 calendar days after the insurer or third-party administrator receives the bill. Except as otherwise provided in this section, if the bill for accident benefits is not paid within that period, the insurer shall pay interest to the provider of health care at a rate of interest equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date on which the payment was due, plus 6 percent. The interest must be calculated from 45 calendar days after the date on which the bill is received until the date on which the bill is paid.
2. If an insurer needs additional information to determine whether to pay or deny a bill for accident benefits received from a provider of health care, the insurer shall notify the provider of health care of his or her request for the additional information within 20 calendar days after the insurer receives the bill. The insurer shall notify the provider of health care of all the specific reasons for the delay in paying or denying the bill for accident benefits. Upon the receipt of such a request, the provider of health care shall furnish the additional information to the insurer within 20 calendar days after receiving the request. If the provider of health care fails to furnish the additional information within that period, the provider of health care is not entitled to the payment of interest to which the provider of health care would otherwise be entitled for the late payment of the bill for accident benefits. The insurer shall pay or deny the bill for accident benefits within 20 calendar days after the insurer receives the additional information. Except as otherwise provided in this subsection, if the bill for accident benefits is not paid within that period, the insurer shall pay interest to the provider of health care at the rate set forth in subsection 1. The interest must be calculated from 20 calendar days after the date on which the insurer receives the additional information until the date on which the bill is paid.
3. An insurer shall not request a provider of health care to resubmit information that the provider of health care has previously provided to the insurer, unless the insurer provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the accident benefits, harass the provider of health care or discourage the filing of claims.
4. An insurer shall not pay only a portion of a bill for accident benefits that is fully payable.
5. The Administrator may require an insurer to provide evidence which demonstrates that the insurer has substantially complied with the requirements of this section, including, without limitation, payment within the time required of at least 95 percent of accident benefits. If the Administrator determines that an insurer is not in substantial compliance with the requirements of this section, the Administrator may require the insurer to pay an administrative fine in an amount to be determined by the Administrator.
6. The payment of interest provided for in this section for a late payment may be waived only if the payment was delayed because of an act of God or another cause beyond the control of the insurer.
7. Payments made by an insurer pursuant to this section are not an admission of liability for the accident benefits or any portion of the accident benefits.
(Added to NRS by 2001, 2736; A 2015, 1134)
Structure Nevada Revised Statutes
Chapter 616C - Industrial Insurance: Benefits for Injuries or Death
NRS 616C.035 - Application for death benefit.
NRS 616C.085 - Duties of employer when employee injured: First aid; reimbursement.
NRS 616C.115 - Prescription of generic drugs required; exceptions.
NRS 616C.117 - Prescription of drugs dispensed directly to injured employee; limitations.
NRS 616C.120 - Employee may elect treatment through prayer in lieu of medical treatment.
NRS 616C.185 - Compensation for mastectomy and reconstructive surgery.
NRS 616C.190 - Compensation of employee injured out of State.
NRS 616C.210 - Compensation of nonresident alien dependents; notification of dependent required.
NRS 616C.300 - Hearing officers: Appointment; salary; disqualification from particular case.
NRS 616C.370 - Judicial review.
NRS 616C.375 - Stay of decision of appeals officer.
NRS 616C.380 - Payment pending appeal when decision not stayed; effect of final resolution of claim.
NRS 616C.385 - Costs and attorney’s fees for frivolous petitions for judicial review.
NRS 616C.400 - Minimum duration of incapacity; exceptions.
NRS 616C.405 - Limitations on benefits received by employee.
NRS 616C.408 - Restrictive endorsements on checks issued by insurers.
NRS 616C.409 - Direct deposit of compensation.
NRS 616C.410 - Prohibition of settlements paid in lump sum; exceptions.
NRS 616C.415 - Written explanation of alternative settlements to be given to employee or dependents.
NRS 616C.420 - Method of determining average monthly wage.
NRS 616C.425 - Date of determination of amount of compensation and benefits.
NRS 616C.435 - Injuries deemed total and permanent.
NRS 616C.455 - Increase in benefits for permanent total disability incurred before April 9, 1971.
NRS 616C.473 - Annual increase in benefits for permanent total disability.
NRS 616C.485 - Permanent partial disability: Loss of or permanent damage to teeth.
NRS 616C.495 - Permanent partial disability: Payments in lump sum.
NRS 616C.505 - Amount and duration of compensation.
NRS 616C.508 - Annual increase in death benefits.
NRS 616C.510 - Increased death benefits if injury or disablement occurred before July 1, 1973.
NRS 616C.520 - Increased death benefits if injury or disablement occurred on or after July 1, 1973.
NRS 616C.530 - Priorities for returning injured employee to work.
NRS 616C.541 - Appointment of vocational rehabilitation counselor.
NRS 616C.543 - Prohibited acts of vocational rehabilitation counselor.
NRS 616C.547 - General duties of vocational rehabilitation counselor.
NRS 616C.560 - Extension of program for vocational rehabilitation.
NRS 616C.570 - On-the-job training as component of plan for program of vocational rehabilitation.
NRS 616C.575 - Payment of vocational rehabilitation maintenance.
NRS 616C.580 - Provision of services outside of State; limited lump-sum payment in lieu of services.
NRS 616C.585 - Limit on goods and services which may be provided; exceptions.
NRS 616C.700 - Duties of insurer who accepts a claim for catastrophic injury; life care plan.
NRS 616C.710 - Rescission or revision of determination of catastrophic injury.
NRS 616C.720 - Requirements for adjuster who administers claim for catastrophic injury.