Any of the following acts by an insurer doing accident and health insurance, property insurance, casualty insurance, surety insurance, marine insurance, or title insurance business, if committed without just cause and performed with such frequency as to indicate a general business practice, constitutes improper claim practices:
(1) Knowingly misrepresenting to insureds or third-party claimants pertinent facts or policy provisions relating to coverages at issue or providing deceptive or misleading information with respect to coverages.
(2) Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies, including third-party claims arising under liability insurance policies.
(3) Failing to adopt and implement reasonable standards for the prompt investigation and settlement of claims, including third-party liability claims, arising under its policies.
(4) Not attempting in good faith to effect prompt, fair, and equitable settlement of claims, including third-party liability claims, submitted to it in which liability has become reasonably clear.
(5) Compelling policyholders or claimants, including third-party claimants under liability policies, to institute suits to recover amounts reasonably due or payable with respect to claims arising under its policies by offering substantially less than the amounts ultimately recovered through suits brought by the claimants or through settlements with their attorneys employed as the result of the inability of the claimants to effect reasonable settlements with the insurers.
(6) Offering to settle claims, including third-party liability claims, for an amount less than the amount otherwise reasonably due or payable based upon the possibility or probability that the policyholder or claimant would be required to incur attorneys' fees to recover the amount reasonably due or payable.
(7) Invoking or threatening to invoke policy defenses or to rescind the policy as of its inception, not in good faith and with a reasonable expectation of prevailing with respect to the policy defense or attempted rescission, but for the primary purpose of discouraging or reducing a claim, including a third-party liability claim.
(8) Any other practice which constitutes an unreasonable delay in paying or an unreasonable failure to pay or settle in full claims, including third-party liability claims, arising under coverages provided by its policies.
HISTORY: Former 1976 Code Section 38-37-1110 [1962 Code Section 37-591.56; 1974 (58) 2718] recodified as Section 38-59-20 by 1987 Act No. 155, Section 1.
Structure South Carolina Code of Laws
Section 38-59-10. Proof of loss forms required to be furnished.
Section 38-59-20. Improper claim practices.
Section 38-59-25. Coverage decisions not constituting practice of medicine.
Section 38-59-30. Notice and hearing by director or designee; penalties.
Section 38-59-40. Liability for attorneys' fees where insurer has refused to pay claim.
Section 38-59-50. Payment or settlement of benefits in merchandise or services prohibited.
Section 38-59-200. Citation of article.
Section 38-59-210. Definitions.
Section 38-59-220. Requesting fee schedule from insurer; confidentiality.
Section 38-59-240. Interest on payments later than applicable period; exceptions.
Section 38-59-250. Initiation of overpayment recovery efforts.
Section 38-59-260. Application of requirements of article.
Section 38-59-270. Enforcement; cease and desist orders; penalty; private right of action.