(3) UNFAIR CLAIM SETTLEMENT PRACTICES.
(a) Any of the following acts, if committed
by any person without just cause and performed with such frequency as to
indicate general business practice, shall constitute unfair methods and
practices in the business of insurance:
1.
Failure to promptly acknowledge pertinent communications with respect to claims
arising under insurance policies.
2. Failure to initiate and conclude a claims
investigation with all reasonable dispatch.
3. Failure to promptly provide necessary
claims forms, instructions and reasonable assistance to insureds and claimants
under its insurance policies.
4.
Failure to attempt in good faith to effectuate fair and equitable settlement of
claims submitted in which liability has become reasonably clear.
5. Failure upon request of a claimant, to
promptly provide a reasonable explanation of the basis in the policy contract
or applicable law for denial of a claim or for the offer of a compromise
settlement.
6. Knowingly
misrepresenting to claimants pertinent facts or policy provisions relating to
coverages involved.
7. Failure to
affirm or deny coverage of claims within a reasonable time after proof of loss
has been completed.
8. Failure to
settle a claim under one portion of the policy coverage in order to influence a
settlement under another portion of the policy coverage.
9. Except as may be otherwise provided in the
policy contract, the failure to offer settlement under applicable first party
coverage on the basis that responsibility for payment should be assumed by
other persons or insurers.
10.
Compelling insureds and claimants to institute suits to recover amounts due
under its policies by offering substantially less than the amounts ultimately
recovered in suits brought by them.
11. Refusing payment of claims solely on the
basis of the insured's request to do so without making an independent
evaluation of the insured's liability based upon all available
information.
12. Failure, where
appropriate, to make use of arbitration procedures authorized or permitted
under any insurance policy.
13.
Adopting or making known to insureds or claimants a policy of appealing from
arbitration awards in favor of insureds or claimants for the purpose of
compelling them to accept settlements or compromises less than the amount
awarded in arbitration.
(b) Any of the following acts committed by
any person shall constitute unfair methods and practices in the business of
insurance:
1. Knowingly misrepresenting to
claimants pertinent facts or policy provisions relating to coverages
involved.
2. Failure to make
provision for adequate claims handling personnel, systems and procedures to
effectively service claims in this state incurred under insurance coverage
issued or delivered in this state.
3. Failure to adopt reasonable standards for
investigation of claims arising under its insurance policies.
4. Violating the requirements established in
s.
632.85,
Stats.
