11 NCAC 04 .0421 HANDLING OF LOSS AND CLAIM PAYMENTS

The commissioner shall consider as prima facie violative of G.S. 58-3-100 and 58-63-15(11) failure by an insurer to
adhere to the following procedures concerning loss and claim payments when such failure is so frequent as to i n d i c a t e
a general business practice:
(1) Loss and claim payments shall be mailed or otherwise delivered within 10 business days after the
claim is settled.
(2) Unless the insured consents, no insurer shall deduct from a loss or claim payment made under one
policy premiums owed by the insured on another policy.
(3) No insurer shall withhold the entire amount of a loss or claim payment because the insured owes
premium or other monies in an amount less than the loss or claim payment.
(4) If a release or full payment of claim is executed by a claimant, involving a repair to a motor vehicle, it
shall not bar the right of the claimant to promptly assert a claim for property damages unknown to
either the claimant or to the insurance carrier prior to the repair of the vehicle, which damages were
directly caused by the accident and which damages could not be determined or known until after the
repair or attempted repair of the motor vehicle. Claims asserted within 30 days after repair shall be
considered promptly asserted.
(5) If a release or full payment of claim is executed by a third party claimant, involving a repair to a
motor vehicle, it shall not bar the right of the third party claimant to promptly assert a claim for
diminished value, which diminished value was directly caused by the accident and which diminished
value could not be determined or known until after the repair or attempted repair of the motor
vehicle. Claims asserted within 30 days after repair for diminished value shall be considered
promptly asserted.

History Note: Authority G.S. 58-2-40; 58-3-100; 58-63-65;
Eff. December 15, 1979;
Amended Eff. February 1, 1996; April 1, 1993; April 1, 1989; July 1, 1986.