Oklahoma § 36-1250.7 - Property and casualty insurer - Denial or acceptance of

§ 36-1250.7. Property and casualty insurer - Denial or acceptance of

claim.

A. Within sixty (60) days after receipt by a property and

casualty 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, or if further investigation is necessary. No

property and casualty insurer shall deny a claim because of a

specific policy provision, condition, or exclusion unless reference

to such provision, condition, or exclusion is included in the

denial. A denial shall be given to any claimant in writing, and the

claim file of the property and casualty insurer shall contain a copy

of the denial. If there is a reasonable basis supported by specific

information available for review by the Commissioner that the first

party claimant has fraudulently caused or contributed to the loss, a

property and casualty insurer shall be relieved from the

requirements of this subsection. In the event of a weather-related

catastrophe or a major natural disaster, as declared by the

Oklahoma Statutes - Title 36. Insurance

Governor, the Insurance Commissioner may extend the deadline imposed

under this subsection an additional twenty (20) days.

B. If a claim is denied for reasons other than those described

in subsection A of this section, and is made by any other means than

writing, an appropriate notation shall be made in the claim file of

the property and casualty insurer until such time as a written

confirmation can be made.

C. Every property and casualty insurer shall complete

investigation of a claim within sixty (60) days after notification

of proof of loss unless such investigation cannot reasonably be

completed within such time. If such investigation cannot be

completed, or if a property and casualty insurer needs more time to

determine whether a claim should be accepted or denied, it shall so

notify the claimant within sixty (60) days after receipt of the

proofs of loss, giving reasons why more time is needed. If the

investigation remains incomplete, a property and casualty insurer

shall, within sixty (60) days from the date of the initial

notification, send to such claimant a letter setting forth the

reasons additional time is needed for investigation. Except for an

investigation of possible fraud or arson which is supported by

specific information giving a reasonable basis for the

investigation, the time for investigation shall not exceed one

hundred twenty (120) days after receipt of proof of loss. Provided,

in the event of a weather-related catastrophe or a major natural

disaster, as declared by the Governor, the Insurance Commissioner

may extend this deadline for investigation an additional twenty (20)

days.

D. 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.

E. Insurers shall not continue or delay negotiations for

settlement of a claim directly with a claimant who is neither an

attorney nor represented by an attorney, for a length of time which

causes the claimant's rights to be affected by a statute of

limitations, or a policy or contract time limit, without giving the

claimant written notice that the time limit is expiring and may

affect the claimant's rights. Such notice shall be given to first

party claimants and third party claimants one year after the date of

the loss.

F. 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 a third party

claimant of the provision of a statute of limitations.

G. If a lawsuit on the claim is initiated, the time limits

provided for in this section shall not apply.

Oklahoma Statutes - Title 36. Insurance

Added by Laws 1986, c. 251, § 18, eff. Nov. 1, 1986. Amended by

Laws 1987, c. 175, § 11, eff. Nov. 1, 1987; Laws 1993, c. 248, § 1,

eff. Sept. 1, 1993; Laws 1994, c. 342, § 7, eff. Sept. 1, 1994.

Renumbered from § 1256 of this title by Laws 1994, c. 342, § 20,

eff. Sept. 1, 1994. Amended by Laws 1997, c. 418, § 54, eff. Nov.

1, 1997; Laws 2018, c. 95, § 7, eff. Nov. 1, 2018; Laws 2021, c.

478, § 8, emerg. eff. May 12, 2021.