South Dakota Codified Laws
Chapter 12 - Insurance Claims And Benefits
Section 58-12-21 - Applicability of §§ 58-12-19 to 58-12-21--Certain policies exempt--No private right of action.

58-12-21. Applicability of §§58-12-19 to 58-12-21--Certain policies exempt--No private right of action.
Sections 58-12-19 to 58-12-21, inclusive, apply to any health insurer or health maintenance organization that issues health insurance coverage pursuant to chapters 58-17, 58-18, 58-18B, 58-37A, 58-38, 58-39, 58-40, and 58-41. Nothing in §§58-12-19 to 58-12-21, inclusive, apply to disability income policies or certificates, accident only, credit health, workers' compensation, long-term care, medicare supplement, automobile medical payment, or other types of health insurance that are not medical expense policies or certificates. Nothing in §§58-12-19 to 58-12-21, inclusive, grants a private right of action.

Source: SL 2001, ch 273, §3.

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Structure South Dakota Codified Laws

South Dakota Codified Laws

Title 58 - Insurance

Chapter 12 - Insurance Claims And Benefits

Section 58-12-1 - Forms for proof of loss--Furnishing by insurer on request.

Section 58-12-2 - Acts of insurer not constituting waiver of policy provision or defense.

Section 58-12-3 - Attorney fees--Recovery in action against self-insured employer or insurer failing to pay loss--Other remedies not barred.

Section 58-12-3.1 - Separate hearing on attorney fees--Adding to judgment--Time allowed to request hearing.

Section 58-12-4 - Life and health insurance--Exemption of benefits and proceeds from execution.

Section 58-12-5 - "Annuity contract" defined.

Section 58-12-6 - Exemption of annuity contract benefits, rights, privileges, and options from execution.

Section 58-12-7 - Premiums paid on annuity with intent to defraud creditors not exempt from execution.

Section 58-12-8 - Maximum amount of annuity exemption--Excess subject to levy.

Section 58-12-9 - Application of excess annuities to judgment--Factors considered.

Section 58-12-10 - Benefits, rights, privileges, or options nontransferable under annuity contract--Not subject to commutation--Exemption from execution.

Section 58-12-11 - Payments under life or health insurance policy or annuity contract discharge insurer.

Section 58-12-12 - Use of uniform health insurance claim forms.

Section 58-12-13 - Use of claim forms required by federal law excepted.

Section 58-12-14 - Promulgation of rules for uniform health insurance claim forms.

Section 58-12-15 - "Paintless dent repair" defined.

Section 58-12-16 - Motor vehicle insurer must provide sufficient compensation to restore vehicle to prior condition--Adjustment for paintless dent repair permitted--Conditions.

Section 58-12-17 - Compensation when paintless dent repair method inappropriate--Requiring unreasonable travel prohibited--Repair shop as payee only if insured agrees.

Section 58-12-18 - Compliance with § 58-12-16.

Section 58-12-19 - Clean claim defined.

Section 58-12-20 - Time limits for processing clean claims--Time limit for additional information required.

Section 58-12-21 - Applicability of §§ 58-12-19 to 58-12-21--Certain policies exempt--No private right of action.

Section 58-12-22 - Information from insurer's database to Department of Social Services--Data match against recipients--Disclosure--Liability.

Section 58-12-23 - Application for or acceptance of medical assistance paid by department operates as release of information to facilitate coordination of benefits--Request.

Section 58-12-24 - Refusal of reimbursement due to manner, form, or date of claim prohibited--Time for submission of claim.

Section 58-12-25 - Reimbursement to department for cost of services.

Section 58-12-26 - Insurer defined.

Section 58-12-27 - Department defined.

Section 58-12-28 - Provisions of chapter 1-27 not applicable to insurer records.

Section 58-12-30 - Annual reports of commercial property casualty insurance claims--Exception--Promulgation of rules.

Section 58-12-31 - Definitions regarding standards for claims processing.

Section 58-12-32 - Application of standards for claims investigation and disposition.

Section 58-12-33 - Flagrant or frequent violations--Notice and opportunity to correct inadvertent violations.

Section 58-12-34 - Acts constituting unfair claims practices.

Section 58-12-35 - Notice of hearing.

Section 58-12-36 - Cease and desist order--Monetary penalty--Suspension or revocation of license.

Section 58-12-37 - Promulgation of rules regarding definitions and records.