QuickServe State Laws

(16) Unfair claim settlement practices.  No person shall commit or perform with such frequency as to indicate a general business practice any of the following: 

a. Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue; 

b. Failing to acknowledge and act reasonably promptly upon communication with respect to claims arising under insurance policies; 

c. Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies; 

d. Refusing to pay claims without conducting a reasonable investigation based upon all available information; 

e. Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed; 

f. Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear; 

The following are hereby defined as unfair methods of competition and unfair or deceptive acts or practices in the business of insurance: 

(1) Misrepresentations and false advertising of insurance policies.  No person shall make, issue, circulate or cause to be made, issued or circulated any estimate, circular, statement, sales presentation, omission or comparison which: 

a. Misrepresents the benefits, advantages, conditions or terms of any insurance policy; 

b. Misrepresents the dividends or share of the surplus to be received on any insurance policy; 

c. Makes any false or misleading statements as to the dividends or share of surplus previously paid on any insurance policy; 

d. Is misleading or is a misrepresentation as to the financial condition of any person, or as to the legal reserve system upon which any life insurer operates; 

(a)  A person engages in a deceptive trade practice when, in the course of a business, vocation, or occupation, that person: 

(1) Passes off goods or services as those of another; 

(2) Causes likelihood of confusion or of misunderstanding as to the source, sponsorship, approval, or certification of goods or services; 

(3) Causes likelihood of confusion or of misunderstanding as to affiliation, connection, or association with, or certification by, another; 

(4) Uses deceptive representations or designations of geographic origin in connection with goods or services; 

(5) Represents that goods or services have sponsorship, approval, characteristics, ingredients, uses, benefits, or quantities that they do not have, or that a person has a sponsorship, approval, status, affiliation, or connection that the person does not have; 

l. Delaying the investigation or payment of claims by requiring an insured, claimant or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information; 

m. Failing to promptly settle claims, where 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; 

n. Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement. 

l. Delaying the investigation or payment of claims by requiring an insured, claimant or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information; 

m. Failing to promptly settle claims, where 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; 

(1) Misrepresentations and false advertising of insurance policies.  No person shall make, issue, circulate or cause to be made, issued or circulated any estimate, circular, statement, sales presentation, omission or comparison which: 

a. Misrepresents the benefits, advantages, conditions or terms of any insurance policy; 

b. Misrepresents the dividends or share of the surplus to be received on any insurance policy; 

c. Makes any false or misleading statements as to the dividends or share of surplus previously paid on any insurance policy; 

d. Is misleading or is a misrepresentation as to the financial condition of any person, or as to the legal reserve system upon which any life insurer operates; 

e. Uses any name or title of any insurance policy or class of insurance policies misrepresenting the true nature thereof; 

f. Is a misrepresentation for the purpose of inducing or tending to induce to the lapse, forfeiture, exchange, conversion or surrender of any insurance policy; 

g. Is a misrepresentation for the purpose of effecting a pledge or assignment of or effecting a loan against any insurance policy; or 

h. Misrepresents any insurance policy as being shares of stock. 

(2) False information and advertising generally.  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, an advertisement, announcement 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 the insurance business, which is untrue, deceptive or misleading. 

(a)  No insurer shall be formed or authorized to transact insurance in this State which has or uses a name which is the same as or deceptively similar to that of another insurer already so authorized without the written consent of such other insurer. 

(b)  No life insurer shall be so authorized which has or uses a name deceptively similar to that of another insurer authorized to transact insurance in this State within the preceding 10 years if life insurance policies originally issued by such other insurer are still outstanding in this State. 

(c)  No insurer shall be formed or authorized to transact insurance which has or uses a name the same as or deceptively similar to that of any foreign insurer not so authorized if such foreign insurer has within the next preceding 12 months signified its intention to secure an incorporation in this State under such name or to do business as a foreign insurer in this State under such name by filing notice of such intention with the Commissioner, unless the written consent to the use of such name or deceptively similar name has been given by such foreign insurer. 

(d)  No foreign insurer seeking admission to this State shall be authorized to transact insurance which has or uses a name the same as or deceptively similar to that of a domestic corporation which has been incorporated as an insurer but has not yet secured a certificate of authority until an expiration of 3 years from date of incorporation of such domestic corporation and of filing with the Commissioner a written notice of intent to use such name. 

(e)  No insurer shall be so authorized which has or uses a name which tends to deceive or mislead as to the type of organization of the insurer. 

(f)  In case of conflict of names between 2 insurers or a conflict otherwise prohibited under this section, the Commissioner may permit (or shall require as a condition to the issuance of an original certificate of authority to an applicant insurer) the insurer to use in this State such supplementation or modification of its name or such business name as may reasonably be necessary to avoid the conflict. 

(1)  Except as otherwise provided in this section a contract for the sale of goods for the price of $500 or more is not enforceable by way of action or defense unless there is some writing sufficient to indicate that a contract for sale has been made between the parties and signed by the party against whom enforcement is sought or by his authorized agent or broker. A writing is not insufficient because it omits or incorrectly states a term agreed upon but the contract is not enforceable under this paragraph beyond the quantity of goods shown in such writing. 

(2)  Between merchants if within a reasonable time a writing in confirmation of the contract and sufficient against the sender is received and the party receiving it has reason to know its contents, it satisfies the requirements of subsection (1) against such party unless written notice of objection to its contents is given within ten days after it is received. 

(a)  Deception, fraud, false pretense, false promise, misrepresentation or the concealment, suppression or omission of any material fact with the intent that others rely upon such concealment, suppression or omission of any material fact in connection with auto repair work by any automotive repair facility, whether or not any person has in fact been misled, deceived or damaged thereby, or the act, use or employment by any auto repair facility of a deceptive trade practice in connection with auto repair work shall constitute an unlawful practice. 

(b)  Acts or practices by an automotive repair facility prohibited by subsection (a) shall include but are not limited to: 

(1) Refusing to return a customer's motor vehicle because the customer refused to pay for unauthorized auto repair work in violation of § 4907A of this title; 

(2) Misrepresenting that auto repair work has been made to a motor vehicle; 

(3) Misrepresenting that auto repair work is necessary to a motor vehicle repair; 

(4) Misrepresenting that the motor vehicle is in a dangerous condition or that the customer's continued use of the vehicle may be harmful or cause significant damage to the vehicle; 

(5) Misrepresenting that the motor vehicle will or will not pass state inspection requirements or is not otherwise in compliance with state or federal requirements in connection with soliciting auto repair work; 

(a)  It is a prohibited telemarketing act or practice and a violation of this chapter and § 2513 of this title for any person to: 

(1) Obtain or submit for payment a check, draft or other form of negotiable paper drawn on a person's checking, savings, share or similar account without that person's express verifiable authorization.  For this purpose, "express verifiable authorization" means: 

a. A written statement signed by the customer expressly authorizing the payment; 

b. The customer's signature on the negotiable instrument; 

c. An oral authorization by the customer that is tape-recorded and made available upon request to the customer's bank and that evidences both the customer's authorization of a payment for the specific merchandise sold and the customer's receipt of the following information: 

1. The date of the draft; 

2. The amount of the draft; 

3. The payor's name; 

4. The number of draft payments, if more than 1; 

(2) of this title notwithstanding, in connection with any door-to-door sale, it is an unlawful practice within the meaning of § 2513 of this title for any seller to: 

(a)  No person shall act as an insurer and no insurer shall transact insurance in this State by mail or otherwise, except as authorized by a subsisting certificate of authority granted to it by the Commissioner and except as to such transactions as are expressly otherwise provided for in this title. 

(b)  No insurer formed under the laws of this State and no insurer from offices or with personnel or facilities located in this State shall solicit insurance applications or otherwise transact insurance in another state or country unless it holds a subsisting certificate of authority granted to it by the Commissioner authorizing it to transact the same kind or kinds of insurance in this State. 

(c)  Any wilful violation of this section by a domestic corporation shall constitute misuse of its corporate powers, and the Attorney General shall proceed for the forfeiture of its charter under § 284 of Title 8. 

(d)  Notwithstanding any other provision of law, and except as provided herein, any person or other entity which provides coverage in this State for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital or optometric expenses, whether such coverage is by direct payment, reimbursement or otherwise, shall be presumed to be subject to the jurisdiction and authority of the Commissioner unless the person or other entity shows that while providing such services it is subject to the jurisdiction of another agency of this or another state, any subdivisions thereof, or the federal government. The jurisdiction and authority of the Commissioner shall be governed by the following provisions: 

§ 2741. Commissioner's authority to promulgate readability rules and regulations.

(a)  In addition to those general powers granted in § 314 of this title, the Commissioner is hereby authorized and empowered to make rules and regulations to the extent the Commissioner deems necessary to assure that automobile insurance policy forms as described in § 2742 of this title are readable and understandable by a person of average intelligence and education; provided, however, that such rules and regulations shall require, in the manner the Commissioner deems appropriate, that all such automobile insurance policy forms shall have a total "readability score" of 40 or more on the Flesch Scale, although forms with a Flesch Test Score of less than 40 may be approved where the length of sentences and words are sufficiently compensated for by compliance with other standards set forth in such rules and regulations. 

(b)  The Commissioner shall adopt and promulgate readability rules and regulations only after a hearing thereon of which notice has been given to all persons subject to the Commissioner's supervision under this title who are to be affected by the proposed rule or regulation. Any readability rules and regulations so adopted and promulgated shall be effective upon the date specified therein. 

§ 4906A. Replaced parts - Requirement for return to the customer.

An automotive repair facility shall offer to return all replaced parts to the customer or a person acting on his or her behalf, except parts which are returned to a manufacturer or distributor, hazardous materials or other items which the automotive repair facility is otherwise required to properly dispose of or recycle. Nothing herein shall require the auto repair facility to retain replaced parts after final invoice.