31 Pa. Code § 146.2

Current through Register Vol. 54, No. 16, April 20, 2024
Section 146.2 - Definitions
(a) The definitions of "person" and of "insurance policy or insurance contract" contained in section 2 of the Unfair Insurance Practices Act (40 P. S. § 1171.2) applies to this chapter.
(b) The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

Agent-An individual, corporation, association, partnership or other legal entity authorized to represent an insurer with respect to a claim.

Claim-A demand for payment by a claimant and not an inquiry concerning coverage.

Claimant-Except as provided in § 146.10 (relating to written notice to claimants of payment of claim in third-party settlements), either a first-party claimant, a third-party claimant, or both, and including the claimant's attorney and a member of the claimant's immediate family designated by the claimant.

Commissioner-The Insurance Commissioner of the Commonwealth.

Department-The Insurance Department of the Commonwealth.

First-party claimant-An individual, corporation, association, partnership or other legal entity asserting a right to payment under an insurance policy or insurance contract arising out of the occurrence of the contingency or loss covered by such policy or contract.

Insured-A natural person, association, corporation, partnership or other legal entity who is insured under an insurance policy or insurance contract issued in this Commonwealth.

Insurer-A person licensed to issue or who issues an insurance policy or insurance contract in this Commonwealth.

Investigation-Activities of an insurer directly or indirectly related to the determination of liabilities under coverages afforded by an insurance policy or insurance contract and settlement of claims or losses thereunder.

Notification of claim-A notification, whether in writing or other means acceptable under the terms of an insurance policy or insurance contract, to an insurer or its agent, by a claimant or insured, which reasonably apprises the insurer of the facts pertinent to a claim.

Third-party claimant-An individual, corporation, association, partnership or other legal entity asserting a claim against an individual, corporation, associa-tion, partnership or other legal entity insured under an insurance policy or insurance contract of an insurer.

(c) The term "worker's compensation," in this chapter, includes but is not limited to Longshoremen's and Harbor Worker's Compensation.

31 Pa. Code § 146.2

The provisions of this § 146.2 adopted December 15, 1978, effective 12/16/1978, 8 Pa.B. 3575; amended February 21, 1992, effective 2/22/1992, 22 Pa.B. 762.