Rhode Island Code of Regulations
Title 230 - Department of Business Regulation
Chapter 20 - Insurance
Subchapter 40 - Claims
Part 1 - Unfair Life, Accident and Health Claims Settlement Practices (230-RICR-20-40-1)
Section 230-RICR-20-40-1.5 - File and Record Documentation
Universal Citation: 230 RI Code of Rules 20 40 1.5
Current through September 18, 2024
A. Each insurer's claim files for policies or certificates are subject to examination by the Director or by his or her duly appointed designees. To aid in the examination:
1. The insurer shall maintain claim data that
are accessible and retrievable for examination. An insurer shall be able to
provide the claim number, line of coverage, date of loss and date of payment of
the claim, date of denial or date closed without payment. This data shall be
available for all open and closed files for the current year and the two (2)
preceding years.
2. Detailed
documentation shall be contained in each claim file in order to permit
reconstruction of the insurer's activities relative to each claim.
3. Each document within the claim file shall
be noted as to date received, date processed or date mailed.
4. For those insurers that do not maintain
hard copy files, claim files must be accessible from a computer monitor or
micrographics and be capable of being printed as hard copy.
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