Utah Administrative Code
Topic - Insurance
Title R590 - Administration
Rule R590-261 - Health Benefit Plan Adverse Benefit Determinations
Section R590-261-6 - Exhaustion of Internal Review Process
Universal Citation: UT Admin Code R 590-261-6
Current through Bulletin 2024-06, March 15, 2024
A carrier's internal review process shall be exhausted before an independent review unless:
(1) the carrier agrees to waive the internal review process;
(2) the carrier did not comply with its internal review process, except for a minor violation that:
(a) does not cause prejudice or harm to the
claimant; and
(b) is not part of a
pattern or practice of violations; or
(3) the claimant requests an expedited independent review pursuant to Section R590-261-10 at the same time the claimant requests an expedited internal review.
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