Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 100 - Insurer Conduct
Chapter 1 - Improper or Unfair Claims Settlement Practices
Section 20 CSR 100-1.020 - Misrepresentation of Policy Provisions in Claims Settlement
Universal Citation: 20 MO Code of State Regs 100-1.020
Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This rule effectuates or aids in the interpretation of section 375.1007(1), RSMo.
(1) An insurer who engaged in one or more of the following acts or practices shall be deemed to be engaged in "misrepresenting policy provisions" as used in section 375.1007(1), RSMo. This rule is not intended to be all inclusive and acts or practices not enumerated in this rule may also be deemed misrepresentation.
(A) No insurer shall fail to fully disclose
to first-party claimants all pertinent benefits, coverages or other provisions
of an insurance policy under which a claim is presented.
(B) No insurance producer shall conceal from
any first-party claimant the benefits, coverages or other provisions of any
insurance policy when these benefits, coverages or other provisions are
pertinent to a claim.
(C) No
insurer shall deny any claim for failure to exhibit the property without proof
of demand and unfounded refusal by a claimant to do so.
(D) No insurer shall deny any claim based
upon the insured's failure to submit a written notice of loss within a
specified time following any loss, unless this failure operates to prejudice
the rights of the insurer.
(E) No
insurer shall request a first-party claimant to sign a release that extends
beyond the subject matter that gave rise to the claim payment.
(F) No insurer shall issue any draft in
partial settlement of a claim under a specific coverage, when endorsement of
the draft would totally release the insurer or its insured from
liability.
*Original authority: 374.045, RSMo 1967, amended 1993, 1995 and 375.1000-375.1018, see RSMo 2000 and RSMo Supp. 2007.
Disclaimer: These regulations may not be the most recent version. Missouri may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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