Indiana § 27-8-5.7-8 Civil penalties

Indiana Statutes

§ 27-8-5.7-8 — Civil penalties

Indiana § 27-8-5.7-8

Title 27INSURANCE

Art. 8LIFE, ACCIDENT, AND HEALTH

Ch. 5.7Accident and Sickness Insurance; Provider Payment

This text of Indiana § 27-8-5.7-8 (Civil penalties) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 27-8-5.7-8 (2026).

Text

(a)If the commissioner finds that an insurer has failed during any calendar year to process and pay clean claims in compliance with this chapter, the commissioner may assess an aggregate civil penalty against the insurer according to the following schedule:

(1)If the insurer has paid at least eighty-five percent (85%) but less than ninety-five percent (95%) of all clean claims received from all providers during the calendar year in compliance with this chapter, a civil penalty of up to ten thousand dollars ($10,000).

(2)If the insurer has paid at least sixty percent (60%) but less than eighty-five percent (85%) of all clean claims received from all providers during the calendar year in compliance with this chapter, a civil penalty of at least ten thousand dollars ($10,000) but not more

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(a) If the commissioner finds that an insurer
has failed during any calendar year to process and pay clean claims in
compliance with this chapter, the commissioner may assess an
aggregate civil penalty against the insurer according to the following
schedule:
(1) If the insurer has paid at least eighty-five percent (85%) but
less than ninety-five percent (95%) of all clean claims received
from all providers during the calendar year in compliance with
this chapter, a civil penalty of up to ten thousand dollars
($10,000).
(2) If the insurer has paid at least sixty percent (60%) but less
than eighty-five percent (85%) of all clean claims received from
all providers during the calendar year in compliance with this
chapter, a civil penalty of at least ten thousand dollars ($10,000)
but not more than one hundred thousand dollars ($100,000).
(3) If the insurer has paid less than sixty percent (60%) of all
clean claims received from all providers during the calendar year
in compliance with this chapter, a civil penalty of at least one
hundred thousand dollars ($100,000) but not more than two
hundred thousand dollars ($200,000).
(b) In determining the amount of a civil penalty under this section,
the commissioner shall consider whether the insurer's failure to achieve
the standards established by this chapter is due to circumstances
beyond the insurer's control.
(c) An insurer may contest a civil penalty imposed under this
section by requesting an administrative hearing under IC 4-21.5 not
more than thirty (30) days after the insurer receives notice of the
assessment of the fine.
(d) If the commissioner imposes a civil penalty under this section,
the commissioner may not impose a penalty against the insurer under
IC 27-4-1 for the same activity.
(e) Civil penalties collected under this section shall be deposited in
the state general fund.