R590-203-6. Disability Income Insurance Adverse Benefit Determination Review

(1) A carrier shall notify a claimant of an adverse benefit determination review within 45 days of receipt of the claimant's request for review of an adverse benefit determination. (2) The time for making an adverse benefit determination review may be extended for up to 45 days if necessary due to matters beyond the carrier's control. (3) If the response time is extended due to the claimant's failure to submit information necessary to decide a claim, the time for making the benefit determination on an adverse benefit determination review shall be tolled from the date on which the notification of the extension is sent until the date on which the claimant responds to the request for additional information. (4) Upon request, relevant information must be provided to the claimant on any adverse benefit determination free of charge.