Unfair Claims Settlement Practices Act

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What Is the Unfair Claims Settlement Practices Act (UCSPA)?

The UCSPA is a model act created by the National Association of Insurance Commissioners to provide guidance for states wishing to protect consumers and regulate insurance carriers. The model act has been adopted in most states.

How Does the Act Regulate Insurance Carriers?

The UCPSA has three general categories of regulation.

(1) Misrepresentations & Bad Faith Practices

The UCSPA prohibits insurance carriers from:

(2) Claim Responses

The act prohibits insurance carriers from:

(3) Investigation

Insurance carriers are required to adopt and implement reasonable standards for prompt investigation of claims and may not refuse to pay a claim without an investigation.

How Is the Act Enforced?

The act allows the state insurance commissioner to enforce the regulations through investigations and sanctions on insurance carriers. Some states also allow individuals to bring private actions against insurance carriers for rule violations.

What Are the Penalties for Rule Violations?

The UCSPA provides for penalties of:

When Should I Contact an Attorney?

If you believe your insurance carrier has violated one of the regulations, you should contact an experienced attorney to learn what relief is available for you in your state.

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Last Modified: 02-12-2014 03:01 PM PST

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