Section 0780-01-04-.08 - CLAIMS AND REVIEW PROCEDURE(1) The insurance company shall be responsible for the settlement, adjustment and payment of all claims and shall establish and maintain adequate claim files, which may be reviewed and examined by the Commissioner. All claims shall be promptly reported to the insurer, or its designated claim representative, and all claims shall be settled as soon as possible and in accordance with the terms of the insurance contract. "Promptly reported" shall mean that adequate proofs of loss are in the possession of the insurer at the time its funds are disbursed in payment of claims. All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of such claimant to the one specified.(2) No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in settling or adjusting claims; provided, that a group policyholder which employs one or more persons for claims and insurance administration who are not directly involved in making loans may, by arrangement with the group insurer, draw drafts or checks in payments of claims due to the group policyholder subject to audit and review by the insurer. However, nothing herein shall be construed to relieve the insurer of the responsibility for the proper settlement, adjustment and payment of all claims in accordance with the terms of the insurance contract and this regulation.(3) It shall be the responsibility of the insurer to make a good faith examination of each lender's account at least annually verifying the accuracy of premiums or other identifiable insurance charges, premium refunds, and claims payments which have been reported to the insurer.Tenn. Comp. R. & Regs. 0780-01-04-.08
Original rule certified June 10, 1974.Authority: T.C.A. §§ 45-5-403, 56-7-901 and 56-8-110.