Florida Statutes, Rules, and Regulations Common to All Lines
A beneficiary receives a claim denial that cites no policy provision and no factual basis, although the insurer did investigate. Has the insurer complied with 626.9541(1)(i)?
Answer and explanation
Answer: B. Section 626.9541(1)(i) reaches two separate failures: denying claims without conducting reasonable investigations, and failing to promptly provide a reasonable explanation for a denial. Conducting the investigation satisfies the first duty but leaves the second unmet, so compliance fails on the explanation. The provision is not limited to uninvestigated claims and does not require prior approval of denials.Source: Fla. Stat. § 626.9541 — (1)(i), Reasonable explanation on denial
More florida statutes, rules, and regulations common to all lines questions
- Which body receives and investigates a Florida insurance licence application?
- Which combination of features identifies a fraternal benefit society under Florida law?
- Which conduct appears among the grounds that compel the Department to act against a licence under section 626.611?
- Which fact distinguishes sliding under 626.9541(1)(z) from churning under 626.9541(1)(aa)?
- Which feature most clearly separates a fraternal benefit society from a stock insurer under Florida law?
- Which feature separates a stock insurer from a fraternal benefit society under Florida law?
589 Florida questions like this one.
Every answer explained, the ones you miss come back on a spaced schedule, and a plan built from your exam date.