Idaho § 41-5605 - Exceptions
Full text of Idaho Idaho Statutes § 41-5605 — Exceptions, with citation guidance and answers to common questions.
§ 41-5605. Exceptions
(1) The time periods set forth in section 41-5602 , Idaho Code, shall not apply to claims that the insurer reasonably believes involve fraud or misrepresentation by the practitioner or facility or the beneficiary or to instances where the insurer has not been provided the information necessary to evaluate the claim after notice has been given requesting additional information by the insurer as required by section 41-5602 (5), Idaho Code.
(2) The time periods set forth in section 41-5602 , Idaho Code, shall not apply to claims that the insurer reasonably believes require medical records, including accident reports, for the purpose of investigating whether a claim is valid for subrogation, or the coordination of benefits payable by the insurer with benefits payable by another insurer or payable under federal or state law.
(3) An insurer is not required to comply with the time periods set forth in section 41-5602 , Idaho Code, if the insurer is in compliance with a contract with the practitioner or facility which specifies different payment requirements. Payments made within the time periods set forth in section 41-5602 , Idaho Code, for the purpose of this chapter, shall be deemed to be made in a reasonable and timely manner.
(4) An insurer is not required to comply with the periods set forth in section 41-5602 , Idaho Code, if the fee or premium entitling a beneficiary to insurance benefits has not been paid in full.
(5) An insurer is not required to comply with the time periods set forth in section 41-5602 , Idaho Code, if failure to comply is due to an act of God, bankruptcy, an act of a governmental authority responding to an act of God or emergency or the result of a strike, walkout or other labor dispute, or act of terrorism.
[41-5605, added 2004, ch. 290, sec. 1, p. 814.]
Frequently Asked Questions About Idaho § 41-5605
What does Idaho Statutes § 41-5605 cover?
Section 41-5605 ("Exceptions") is part of the Idaho Statutes, the codified statutory law of Idaho. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Idaho § 41-5605?
A common citation format is "Idaho Statutes § 41-5605" (Idaho). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Idaho law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Idaho official source linked on this page or consult a licensed Idaho attorney.
How does Idaho § 41-5605 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Idaho can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Idaho.