LIS

Administrative Code

Creating a Report: Check the sections you'd like to appear in the report, then use the "Create Report" button at the bottom of the page to generate your report. Once the report is generated you'll then have the option to download it as a pdf, print or email the report.

Virginia Administrative Code
Title 14. Insurance
Agency 5. State Corporation Commission, Bureau of Insurance
Chapter 400. Rules Governing Unfair Claim Settlement Practices
12/5/2024

14VAC5-400-50. Acknowledgment of pertinent communications.

A. An insurer, upon receiving notification of a claim shall, within 15 calendar days, acknowledge the receipt of such notice to the claimant unless payment is made within such period of time, except that if a provider submits a claim, acknowledgment of the claim is satisfied if payment or denial of the claim is made to the provider within 21 calendar days. If an acknowledgment is made by means other than writing, an appropriate notation of such acknowledgment shall be made in the claim file of the insurer and dated. Notification given by a claimant to an agent of an insurer shall be notification to the insurer.

B. Upon receipt of any inquiry from the commission respecting a claim, an insurer shall furnish a complete response to the inquiry within 15 calendar days of receipt.

C. An appropriate reply shall be made within 15 calendar days on all other pertinent communications from a claimant that reasonably suggest that a response is expected.

D. Upon receiving notification of a claim, an insurer shall promptly provide necessary claim forms, instructions, and reasonable assistance in order for the claimant to comply with the applicable policy conditions and the insurer's reasonable requirements. Compliance with this subsection within 15 calendar days of notification of a claim shall constitute compliance with subsection A of this section.

Statutory Authority

§§ 12.1-13, 38.2-223, and 38.2-510 of the Code of Virginia.

Historical Notes

Derived from Regulation 12, Case No. 19961, § 6, eff. September 15, 1978; amended, Virginia Register Volume 33, Issue 22, eff. January 1, 2018.

Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader's convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.