2010 North Carolina Code
Chapter 58 Insurance.
Article 67 - Health Maintenance Organization Act.
58-67-135. Incurred but not reported claims.
58‑67‑135. Incurred but not reported claims.
(a) Every HMO shall, when determining liability, include an amount estimated in the aggregate to provide for any unearned premium and for the payment of all claims for health care expenditures that have been incurred, whether reported or unreported, that are unpaid and for which such HMO is or may be liable; and to provide for the expense of adjustment or settlement of such claims.
(b) Such liabilities shall be computed in accordance with rules adopted by the Commissioner upon reasonable consideration of the ascertained experience and character of the HMO. (1989, c. 776, s. 13.)
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