Anti-Steering Regulations
Administrative Code 20-6-801
3. Insurers shall not require a claimant to
travel unreasonably either to inspect a replacement automobile, to obtain a
repair estimate or to have the automobile repaired at a specific repair shop.
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http://www.sosaz.com/public_services/Title_20/20-06.htm#ARTICLE%208.%20PROHIBITED%20PRACTICES,%20PENALTIES
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Caps
According to a data the Society for Collision Repair Specialists collected
between 1995 and 1999 Caps in Arizona are illegal. In other words, insurers
cannot put a limit on what they will pay for a product, procedure or repair. We
published a story on caps including a table with the data collected by SCRS in
our February 2000 issue.
Generic Caps Letter
|
______________ Insurance
Insured:
______________________
Claim #:
______________________
Vehicle ID:
Attn: Customer Service
In your repair appraisal of my vehicle, you limited paint/paint materials
payment and/or related costs, such as refinish labor, to $___, while my cost
is $___, or $___ more than you allow.
Your policy with me promises to restore my car to preloss condition at no
cost other than the deductible my policy specifies. If I have to pay more
than you allow for paint/materials and other costs, I will have to pay my
deductible plus $___ before my car will be returned to me. Please tell me
exactly where my policy says you may limit payments for paint/materials and
other costs. If you can't, please authorize the full cost, $___, for all
expenses.
If you don't authorize full pay and you can't show me where my policy
says you may restrict payment, I shall report this incident to [State]
Department of Insurance, stating that ____________ Insurance isn't honoring
its promise to restore my vehicle to preloss condition at no cost other than
the deductible as called for in the policy.
I look forward to your prompt response; I'd like my vehicle repaired as
quickly as possible.
Sincerely,
cc: Insurance Commissioner |
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Consumer Auto Repair
Practices Acts
We have not found any law yet.
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Consumer Sales Practices Acts
We have not found any law yet.
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Diminished Value
R20-6-801. Unfair Claims Settlement Practices
H. Standards for prompt, fair and equitable
settlements applicable to automobile insurance
6. When the amount claimed is reduced because of
betterment or depreciation all information for such reduction shall be
contained in the claim file. Such deductions shall be itemized and specified
as to dollar amount and shall be appropriate for the amount of deductions.
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False & Misleading
Advertising
Misrepresentations and false advertising of policies
20-443
A person shall not make, issue or circulate, or cause to be made, issued or
circulated, any estimate, illustration, circular, sales material or statement:
1. Misrepresenting the terms of any policy issued or to be issued or the
benefits or advantages promised or the dividends or share of the surplus to be
received.
2. Making any false or misleading statement as to the dividends or share of
surplus previously paid on similar policies.
Update>>
http://www.azleg.state.az.us/ars/20/00443.htm
False or deceptive advertising of insurance or status
as insurer 20-444
A. No person shall make, publish, disseminate, circulate or place before the
public, or cause, directly or indirectly, to be made, published, disseminated,
circulated or placed before the public, in a newspaper, magazine or other
publication, or in the form of a notice, circular, pamphlet, letter or poster,
or over any radio or television station, or in any other way, any
advertisement, announcement, sales material or statement containing any
assertion, representation or statement with respect to the business of
insurance or with respect to any person in the conduct of his insurance
business, which is untrue, deceptive or misleading.
B. No person that is not an insurer shall assume or use any name which
deceptively infers or suggests that it is an insurer.
Update>>
http://www.azleg.state.az.us/ars/20/00444.htm
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False Use of Insurer’s Name
Name of insurer Section
20-218
A. No insurer shall be authorized to transact insurance in this state which
has or uses a name so similar to that of any insurer already so authorized as
to cause uncertainty or confusion. In case of conflict of names between two
insurers the director may permit or require the newly authorized insurer to use
in this state such supplementation or modification of its name as may
reasonably be necessary to avoid such conflict.
B. No insurer shall be authorized to transact insurance in this state which
has or uses a name which tends to deceive or mislead as to the type of
organization of the insurer.
Update>>
http://www.azleg.state.az.us/ars/20/00218.htm
False or deceptive advertising of insurance or status
as insurer 20-444
B. No person that is not an insurer shall assume or use any name which
deceptively infers or suggests that it is an insurer.
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http://www.azleg.state.az.us/ars/20/00444.htm
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Home Sales Act
CHAPTER 15 - HOME SOLICITATIONS AND REFERRAL SALES
44-5001 to 5008
In this chapter, unless the context otherwise requires:
1. "Home solicitation sale" means a sale of goods or services in which the
seller or his representative personally solicits the sale and the buyer's
agreement or offer to purchase is made at a home other than that of the person
soliciting the same and that agreement or offer to purchase is there given to
the seller or his representative and all or any part of the purchase price is
payable in installments, or a debt incurred for payment of the purchase price
is payable in installments. A sale which otherwise meets the definition of a
home solicitation sale, except that it is a cash sale, shall be deemed to be a
home solicitation sale if the seller makes or provides a loan to the buyer or
obtains or assists in obtaining a loan for the buyer to pay the purchase price.
A sale is not a "home solicitation sale" if it is pursuant to a preexisting
account with a seller whose primary business is that of selling goods or
services at a fixed location or if it is a sale made pursuant to prior
negotiations between the parties at a business establishment at a fixed
location where goods or services are offered or exhibited for sale.
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http://www.azleg.state.az.us/ars/44/title44.htm
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Imitation Crash Parts Regulations
(referring to a code number if it’s in the UCP Act)
Title 20, Chapter 2, Article 6, 20-461 -- it's under
point 15 in the Unfair Claims Settlement Practices Act
15. Attempting to settle claims for the replacement of any nonmechanical
sheet metal or plastic part which generally constitutes the exterior of a motor
vehicle, including inner and outer panels, with an aftermarket crash part which
is not made by or for the manufacturer of an insured's motor vehicle unless the
part meets the specifications of section 44-1292 and unless the consumer is
advised in a written notice attached to or printed on a repair estimate which:
(a) Clearly identifies each part.
(b) Contains the following information in ten point or larger type:
"This estimate has been prepared based on the use of replacement parts
supplied by a source other than the manufacturer of your motor vehicle.
Warranties applicable to these replacement parts are provided by the
manufacturer or distributor of these parts rather than the manufacturer of your
vehicle."
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http://www.azleg.state.az.us/ars/20/00461.htm
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Licensing Adjusters
Licensing of adjusters; qualifications; exemption
20-321.01.
A. A person shall not act as or claim to be an adjuster unless the person is
licensed under this article.
B. To obtain a license as an adjuster a person shall apply to the director
for the license and use the forms prescribed and provided by the director. The
director shall issue the license to qualified persons on payment of the license
fee prescribed in section 20-167.
C. To be licensed as an adjuster the applicant shall meet all of the
following qualifications:
1. Be a person who is at least eighteen years of age.
2. Be a resident of this state, or a resident of another state that allows
residents of this state to act as adjusters in the other state.
3. Take and pass an examination that is given by or under the supervision of
the director and that reasonably tests the applicant's knowledge of insurance
and legal responsibilities as an adjuster.
4. Have and maintain in this state an office accessible to the public and
keep at the office the usual and customary records pertaining to transactions
under the license. This paragraph does not prohibit maintaining an office in
the home of the licensee.
D. A firm or corporation, whether or not organized under the laws of this
state, may be licensed as an adjuster if each individual who is to exercise the
license powers is qualified for an individual license as an adjuster.
E. An adjuster who is licensed or permitted to act as an adjuster in the
state of the adjuster's domicile is not required to be licensed pursuant to
this section or meet the qualifications prescribed in this section if the
adjuster is sent to this state on behalf of an insurer for the purpose of
investigating or making adjustment of a particular loss under an insurance
policy or a series of losses resulting from a catastrophe common to all those
losses.
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http://www.azleg.state.az.us/ars/20/00321-01.htm
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Telemarketing laws
Violation; classification 44-1277.
A. Except as provided in section 44-1273, it is unlawful for a seller to
engage in a telephone solicitation unless the seller is registered pursuant to
section 44-1272.
B. A seller or solicitor engaged in a recovery service shall not charge or
receive any money or other valuable consideration from a consumer before full
and complete performance of the service that the seller or solicitor has agreed
to perform for or on behalf of the consumer.
C. A seller or solicitor who violates this section is guilty of a class 5
felony.
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http://www.azleg.state.az.us/ars/44/title44.htm Article 6
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Timely Notification
2. Failing to acknowledge and act reasonably and promptly upon
communications with respect to claims arising under an insurance policy.
5. Failing to affirm or deny coverage of claims within a reasonable time
after proof of loss statements have been completed.
6. Not attempting in good faith to effectuate prompt, fair and equitable
settlements of claims in which liability has become reasonably clear.
7. Compelling insureds to institute litigation to recover amounts due under
an insurance policy by offering substantially less than the amounts ultimately
recovered in actions brought by the insureds.
8. Attempting to settle a claim for less than the amount to which a
reasonable person would have believed he was entitled by reference to written
or printed advertising material accompanying or made part of an application.
13. Failing to promptly settle claims if liability has become reasonably
clear under one portion of the insurance policy coverage in order to influence
settlements under other portions of the insurance policy coverage.
Update>>
http://www.azleg.state.az.us/ars/20/00461.htm point 5 and 6 in Unfair
Claims Settlement Practices
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Timely Payment
Timely payment of claims 20-462
A. From and after July 15, 1986 any first party claim not paid within thirty
days after the receipt of an acceptable proof of loss by the insurer which
contains all information necessary for claim adjudication shall be required to
pay interest at the legal rate from the date the claim is received by the
insurer. The interest shall be calculated on the amount the insurer is legally
obligated to pay according to the terms of the insurance contract under which
the claim is being submitted.
B. For purposes of determining whether the claim has been paid within thirty
days, the date of payment shall be deemed to have been received by the
addressee on the date shown by the postmark or other official mark of the
United States mail stamped on the payment envelope. If the receipt disputes the
date where there is no mark or the mark is not legible, the sender may
establish the mailing or transfer date by competent evidence.
Update>>
http://www.azleg.state.az.us/ars/20/00462.htm
E. Failure to acknowledge pertinent
communications
1. Every insurer, upon receiving notification of a claim
shall, within 10 working days, acknowledge the receipt of such notice unless
payment is made within such period of time. 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 to an
agent of an insurer shall be notification to the insurer.
2. Every insurer, upon receipt of any inquiry from the
Department of Insurance respecting a claim shall, within fifteen working days
of receipt of such inquiry, furnish the Department with an adequate response to
the inquiry.
3. An appropriate reply shall be made within 10 working days
on all other pertinent communications from a claimant which reasonably suggest
that a response is expected.
4. Every insurer, upon receiving notification of claim,
shall promptly provide necessary claim forms, instructions, and reasonable
assistance so that first party claimants can comply with the policy conditions
and the insurer's reasonable requirements. Compliance with this paragraph
within 10 working days of notification of a claim shall constitute compliance
with paragraph (1) of this subsection.
F. Standards for prompt investigation of claims. Every
insurer shall complete investigation of a claim within 30 days after
notification of claim, unless such investigation cannot reasonably be completed
within such time.
G. Standards for prompt, fair and equitable settlements
applicable to all insurers
1. Notice of acceptance of denial of claim.
a. Within fifteen working days after receipt by the insurer
of properly executed proofs of loss, the first party claimant shall be advised
of the acceptance or denial of the claim by the insurer. No insurer shall deny
a claim on the grounds of a specific policy provision, condition, or exclusion
unless reference to such provision, condition or exclusion is included in the
denial. The denial must be given to the claimant in writing and the claim file
of the insurer shall contain a copy of the denial.
b. If the insurer needs more time to determine whether a
first party claim should be accepted or denied, it shall also notify the first
party claimant within fifteen working days after receipt of the proofs of loss,
giving the reasons more time is needed. If the investigation remains
incomplete, the insurer shall, 45 days from the date of the initial
notification and every 45 days thereafter, send to such claimant a letter
setting forth the reasons additional time is needed for investigation.
c. Where there is a reasonable basis supported by specific
information available for review by the Director for suspecting that the first
party claimant has fraudulently caused or contributed to the loss by arson, the
insurer is relieved from the requirements of subparagraphs (a) and (b) above.
Provided, however, that the claimant shall be advised of the acceptance or
denial of the claim by the insurer within a reasonable time for full
investigation after receipt by the insurer of a properly executed proof of
loss.
2. If a claim is denied for reasons other than those
described in subparagraph (a) above, and is made by any other means than
writing, an appropriate notation shall be made in the claim file of the
insurer.
3. Insurers shall not fail to settle first party claims on
the basis that responsibility for payment should be assumed by others, except
as may otherwise be provided by policy provisions.
4. Insurers shall not continue negotiations for settlement
of a claim directly with a claimant who is neither an attorney nor represented
by an attorney until the claimant's rights may be affected by a statute of
limitations or a policy or contract time limit, without giving the claimant
written notice that the time limit may be expiring and may affect the
claimant's right. Such notice shall be given to first party claimants 30 days
and to third party claimants 60 days before the date on which such time limit
may expire.
5. No insurer shall make statements which indicate that the
rights of a third party claimant may be impaired if a form or release is not
completed within a given period of time unless the statement is given for the
purpose of notifying the third party claimant of the provision of a statute of
limitations.
H. Standards for prompt, fair and equitable settlements
applicable to automobile insurance
1. When the insurance policy provides for the adjustment and
settlement of first party automobile total losses on the basis of actual cash
value or replacement with another of like kind and quality, 1 of the following
methods must apply:
a. The insurer may elect to offer a replacement automobile
which is a specific comparable automobile available to the insured, with all
applicable taxes, license fees and other fees incident to transfer of evidence
of ownership of the automobile paid, at no cost other than any deductible
provided in the policy. The offer and any rejection thereof must be documented
in the claim file.
b. The insurer may elect a cash settlement based upon the
actual cost, less any deductible provided in the policy, to purchase a
comparable automobile including all applicable taxes, license fees and other
fees incident to transfer of evidence of ownership of a comparable automobile.
Such cost may be determined by:
i. The cost of a comparable automobile in the local market
area when a comparable automobile is available in the local market area.
ii. One of 2 or more quotations obtained by the insurer from
2 or more qualified dealers located within the local market area when a
comparable automobile is not available in the local market area.
c. When a first party automobile total loss is settled on a
basis which deviates from the methods described in subparagraphs (a) and (b)
above, the deviation must be supported by documentation giving particulars of
the automobile condition. Any deductions from such cost, including deduction
for salvage, must be measurable, discernible, itemized and specified as to
dollar amount and shall be appropriate in amount. The basis for such settlement
shall be fully explained to the first party claimant.
2. Where liability and damages are reasonably clear,
insurers shall not recommend that third party claimants make claim under their
own policies solely to avoid paying claims under such insurer's policy or
insurance contract.
3. Insurers shall not require a claimant to travel
unreasonably either to inspect a replacement automobile, to obtain a repair
estimate or to have the automobile repaired at a specific repair shop.
4. Insurers shall, upon the claimant's request, include the
first party claimant's deductible, if any, in subrogation demands. Subrogation
recoveries shall be shared on a proportionate basis with the first party
claimant, unless the deductible amount has been otherwise recovered. No
deduction for expenses can be made from the deductible recovery unless an
outside attorney is retained to collect such recovery. The deduction may then
be for only a pro rata share of the allocated loss adjustment expense.
5. If an insurer prepares an estimate of the cost of
automobile repairs, such estimate shall be in an amount for which it may be
reasonably expected the damage can be satisfactorily repaired. The insurer
shall give a copy of the estimate to the claimant and may furnish to the
claimant the names of 1 or more conveniently located repair shops.
6. When the amount claimed is reduced because of betterment
or depreciation all information for such reduction shall be contained in the
claim file. Such deductions shall be itemized and specified as to dollar amount
and shall be appropriate for the amount of deductions.
7. When the insurer elects to repair and designates a
specific repair shop for automobile repairs, the insurer shall cause the
damaged automobile to be restored to its condition prior to the loss at no
additional cost to the claimant other than as stated in the policy and within a
reasonable period of time.
8. The insurer shall not use as a basis for cash settlement
with a first party claimant an amount which is less than the amount which the
insurer would pay if the repairs were made, other than in total loss
situations, unless such amount is agreed to by the insured.
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Total Losses
H. Standards for prompt, fair and
equitable settlements applicable to automobile insurance Administrative Code
20-6-801
1. When the insurance policy provides for the adjustment and
settlement of first party automobile total losses on the basis of actual cash
value or replacement with another of like kind and quality, 1 of the following
methods must apply:
a. The insurer may elect to offer a replacement automobile
which is a specific comparable automobile available to the insured, with all
applicable taxes, license fees and other fees incident to transfer of evidence
of ownership of the automobile paid, at no cost other than any deductible
provided in the policy. The offer and any rejection thereof must be documented
in the claim file.
b. The insurer may elect a cash settlement based upon the
actual cost, less any deductible provided in the policy, to purchase a
comparable automobile including all applicable taxes, license fees and other
fees incident to transfer of evidence of ownership of a comparable automobile.
Such cost may be determined by:
i. The cost of a comparable automobile in the local market
area when a comparable automobile is available in the local market area.
ii. One of 2 or more quotations obtained by the insurer from
2 or more qualified dealers located within the local market area when a
comparable automobile is not available in the local market area.
c. When a first party automobile total loss is settled on a
basis which deviates from the methods described in subparagraphs (a) and (b)
above, the deviation must be supported by documentation giving particulars of
the automobile condition. Any deductions from such cost, including deduction
for salvage, must be measurable, discernible, itemized and specified as to
dollar amount and shall be appropriate in amount. The basis for such settlement
shall be fully explained to the first party claimant.
2. Where liability and damages are reasonably clear,
insurers shall not recommend that third party claimants make claim under their
own policies solely to avoid paying claims under such insurer's policy or
insurance contract.
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