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| 1 | AN ACT concerning regulation.
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| 2 | Be it enacted by the People of the State of Illinois,
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| 3 | represented in the General Assembly:
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| 4 | Section 5. The Illinois Insurance Code is amended by | |||||||||||||||||||
| 5 | changing Section 154.6 as follows:
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| 6 | (215 ILCS 5/154.6) (from Ch. 73, par. 766.6)
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| 7 | Sec. 154.6. Acts constituting improper claims practice. | |||||||||||||||||||
| 8 | Any of the
following acts by a company, if committed without | |||||||||||||||||||
| 9 | just cause and in
violation of Section 154.5, constitutes an | |||||||||||||||||||
| 10 | improper claims practice:
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| 11 | (a) Knowingly misrepresenting to claimants and insureds | |||||||||||||||||||
| 12 | relevant
facts or policy provisions relating to coverages at | |||||||||||||||||||
| 13 | issue;
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| 14 | (b) Failing to acknowledge with reasonable promptness | |||||||||||||||||||
| 15 | pertinent
communications with respect to claims arising under | |||||||||||||||||||
| 16 | its policies;
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| 17 | (c) Failing to adopt and implement reasonable standards for | |||||||||||||||||||
| 18 | the
prompt investigations and settlement of claims arising | |||||||||||||||||||
| 19 | under its policies;
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| 20 | (d) Not attempting in good faith to effectuate prompt, fair | |||||||||||||||||||
| 21 | and
equitable settlement of claims submitted in which liability | |||||||||||||||||||
| 22 | has become
reasonably clear;
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| 23 | (e) Compelling policyholders to institute suits to recover | |||||||||||||||||||
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| 1 | amounts
due under its policies by offering substantially less | ||||||
| 2 | than the amounts
ultimately recovered in suits brought by them;
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| 3 | (f) Engaging in activity which results in a | ||||||
| 4 | disproportionate number
of meritorious complaints against the | ||||||
| 5 | insurer received by the Insurance
Department;
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| 6 | (g) Engaging in activity which results in a | ||||||
| 7 | disproportionate number
of lawsuits to be filed against the | ||||||
| 8 | insurer or its insureds by
claimants;
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| 9 | (h) Refusing to pay claims without conducting a reasonable
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| 10 | investigation based on all available information;
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| 11 | (i) Failing to affirm or deny coverage of claims within a | ||||||
| 12 | reasonable
time after proof of loss statements have been | ||||||
| 13 | completed;
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| 14 | (j) Attempting to settle a claim for less than the amount | ||||||
| 15 | to which a
reasonable person would believe the claimant was | ||||||
| 16 | entitled, by reference
to written or printed advertising | ||||||
| 17 | material accompanying or made part of
an application or | ||||||
| 18 | establishing unreasonable caps or limits on paint
or materials
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| 19 | when estimating vehicle repairs;
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| 20 | (k) Attempting to settle claims on the basis of an | ||||||
| 21 | application which
was altered without notice to, or knowledge | ||||||
| 22 | or consent of, the insured;
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| 23 | (l) Making a claims payment to a policyholder or | ||||||
| 24 | beneficiary
omitting the coverage under which each payment is | ||||||
| 25 | being made;
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| 26 | (m) Delaying the investigation or payment of claims by | ||||||
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| 1 | requiring an
insured, a claimant, or the physicians of either | ||||||
| 2 | to submit a preliminary
claim report and then requiring | ||||||
| 3 | subsequent submission of formal proof of
loss forms, resulting | ||||||
| 4 | in the duplication of verification;
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| 5 | (n) Failing in the case of the denial of a claim or the | ||||||
| 6 | offer of a
compromise settlement to promptly provide a | ||||||
| 7 | reasonable and accurate
explanation of the basis in the | ||||||
| 8 | insurance policy or applicable law for
such denial or | ||||||
| 9 | compromise settlement;
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| 10 | (o) Failing to provide forms necessary to present claims | ||||||
| 11 | within 15
working days of a request with such explanations as | ||||||
| 12 | are necessary to use
them effectively;
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| 13 | (p) Failing to adopt and implement reasonable standards to | ||||||
| 14 | verify that
a repairer designated by the insurance company to | ||||||
| 15 | provide an estimate,
perform repairs, or engage in any other | ||||||
| 16 | service in connection with an
insured loss on a vehicle is duly | ||||||
| 17 | licensed under Section 5-301 of the
Illinois Vehicle Code;
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| 18 | (q) Failing to provide as a persistent tendency a | ||||||
| 19 | notification on any
written estimate prepared by an insurance | ||||||
| 20 | company in connection with an
insured loss that Illinois law | ||||||
| 21 | requires that vehicle repairers must be
licensed in accordance | ||||||
| 22 | with Section 5-301 of the Illinois Vehicle Code;
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| 23 | (r) Failing to pay applicable tax, title, and transfer fees | ||||||
| 24 | for all first-party and third-party claims on a replacement | ||||||
| 25 | vehicle in a private passenger automobile total loss vehicle | ||||||
| 26 | claim; | ||||||
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| 1 | (s) (r) Engaging in any other acts which are in substance | ||||||
| 2 | equivalent to
any of the foregoing.
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| 3 | (Source: P.A. 90-340, eff. 8-8-97.)
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| 4 | Section 99. Effective date. This Act takes effect upon | ||||||
| 5 | becoming law.
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