§ 33-33-202 — Standards For Property And Casualty Insurers

33-33-202 . Standards for property and casualty insurers. (1) Property or casualty insurers seeking utilization reviews with respect to insurance contracts issued in this state may use only utilization review organizations that meet the requirements of this part and any rules adopted pursuant to this part.
(2) A property or casualty insurer is responsible for:
(a) monitoring all utilization review activities carried out by or on behalf of the property or casualty insurer;
(b) ensuring that all requirements of this part and rules adopted pursuant to this part are met; and
(c) ensuring that appropriate personnel have operational responsibility for and oversight of the performance of the property or casualty insurer's utilization review program and contracts with utilization review organizations.
(3) A property or casualty insurer that denies, in whole or in part, a policyholder's claim after consideration of a utilization review shall provide the policyholder an opportunity to request reconsideration by the insurer and the opportunity to submit additional information relating to the claim.

Legislative History

En. Sec. 5, Ch. 335, L. 2001; amd. Sec. 36, Ch. 157, L. 2023.