R590-190-3. Definitions

Terms used in this rule are defined in Section 31A-1-301. Additional terms are defined as follows: (1) "Authorized agent" means an individual, corporation, association, organization, partnership, or other legal entity authorized to represent an insurer with respect to a claim. (2) "Claim file" means a record either in its original form or as recorded by a process that can accurately and reliably reproducer the original material regarding a claim, its investigation, adjustment, and settlement. (3)(a) "Claimant" means a first party claimant, a third party claimant, or both. (b) "Claimant" includes a claimant's designated legal representative and an immediate family member. (4) "Day" means calendar day. (5) "Documentation" means a physical or an electronic record related to a claim. (6)(a) "First party claimant" means a person asserting a right to a benefit under a policy to which the person is a party. (b) "First party claimant" includes a person's designated legal representative and an immediate family member. (7) "General business practice" means a pattern of conduct in a business. (8) "Investigation" means an activity by or on behalf of an insurer related to determining a claim under a policy. (9) "Notice of loss" means a claimant's notice that reasonably informs an insurer of facts related to a claim. (10) "Proof of loss" means an insured's reasonable documentation in support of a claim. (11) "Third party claimant" means a person asserting a claim against an insured.