Oklahoma § 36-1250.4 - Claim files - Examination - Response to inquiries

§ 36-1250.4. Claim files - Examination - Response to inquiries

A. An insurer's claim files shall be subject to examination by

the Insurance Commissioner or by duly appointed designees. Such

files shall contain all notes and work papers pertaining to a claim

in such detail that pertinent events and the dates of such events

can be reconstructed. In addition, the Insurance Commissioner,

authorized employees and examiners shall have access to any of an

insurer's files that may relate to a particular complaint under

investigation or to an inquiry or examination by the Insurance

Department.

B. Any person subject to the jurisdiction of the Commissioner,

upon receipt of any inquiry from the Commissioner shall, within

twenty (20) calendar days from the date of receipt of the inquiry,

furnish the Commissioner with an adequate response to the inquiry.

The Commissioner may, upon good cause shown and on a case-by-case

basis, extend the time allowed for a response for up to seven (7)

additional calendar days. Any inquiry or response subject to this

subsection shall be delivered electronically.

C. Every insurer, upon receipt of any pertinent written

communication including but not limited to e-mail or other forms of

written electronic communication, or documentation by the insurer of

a verbal communication from a claimant which reasonably suggests

that a response is expected, shall, within thirty (30) days after

receipt thereof, furnish the claimant with an adequate response to

the communication.

D. Any violation by an insurer of this section shall subject

the insurer to discipline including a civil penalty of not less than

One Hundred Dollars ($100.00) nor more than Five Thousand Dollars

($5,000.00).

Added by Laws 1986, c. 251, § 15, eff. Nov. 1, 1986. Amended by

Laws 1989, c. 181, § 1, eff. Nov. 1, 1989; Laws 1994, c. 342, § 4,

eff. Sept. 1, 1994. Renumbered from § 1253 of this title by Laws

1994, c. 342, § 20, eff. Sept. 1, 1994. Amended by Laws 1994, 2nd

Ex. Sess., c. 1, § 5, emerg. eff. Nov. 4, 1994; Laws 1997, c. 418, §

51, eff. Nov. 1, 1997; Laws 2010, c. 222, § 24, eff. Nov. 1, 2010;

Laws 2013, c. 254, § 20, eff. Jan. 1, 2015; Laws 2018, c. 95, § 4,

eff. Nov. 1, 2018; Laws 2019, c. 294, § 1, eff. Nov. 1, 2019.

Oklahoma Statutes - Title 36. Insurance