2019 Maryland Code
Insurance
Title 27 - Unfair Trade Practices and Other Prohibited Practices
Subtitle 3 - Unfair Claim Settlement Practices
§ 27-303. Unfair claim settlement practices -- In general

Universal Citation: MD Ins Code § 27-303 (2019)

    It is an unfair claim settlement practice and a violation of this subtitle for an insurer, nonprofit health service plan, or health maintenance organization to:

        (1)    misrepresent pertinent facts or policy provisions that relate to the claim or coverage at issue;

        (2)    refuse to pay a claim for an arbitrary or capricious reason based on all available information;

        (3)    attempt to settle a claim based on an application that is altered without notice to, or the knowledge or consent of, the insured;

        (4)    fail to include with each claim paid to an insured or beneficiary a statement of the coverage under which payment is being made;

        (5)    fail to settle a claim promptly whenever liability is reasonably clear under one part of a policy, in order to influence settlements under other parts of the policy;

        (6)    fail to provide promptly on request a reasonable explanation of the basis for a denial of a claim;

        (7)    fail to meet the requirements of Title 15, Subtitle 10B of this article for preauthorization for a health care service;

        (8)    fail to comply with the provisions of Title 15, Subtitle 10A of this article;

        (9)    fail to act in good faith, as defined under § 27–1001 of this title, in settling a first–party claim under a policy of property and casualty insurance; or

        (10)    fail to comply with the provisions of § 16–118 of this article.

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