<section number="31A-26-301"><effdate>5/6/2026</effdate><histories><history>Amended by Chapter <modchap sess="2026GS">45</modchap>, 2026 General Session</history><modyear>2026</modyear></histories><catchline>Timely payment of claims.</catchline><subsection number="31A-26-301(1)"><subsection number="31A-26-301(1)(a)">Unless otherwise provided by law, an insurer shall timely pay every valid insurance claim made by an insured.</subsection><subsection number="31A-26-301(1)(b)">By rule the commissioner may prescribe:<subsection number="31A-26-301(1)(b)(i)">the kinds of notice and proof of loss that will establish validity;</subsection><subsection number="31A-26-301(1)(b)(ii)">the manner in which an insurer may make a bona fide denial of a claim;</subsection><subsection number="31A-26-301(1)(b)(iii)">the periods of time within which payment is required to be made to be timely; and</subsection><subsection number="31A-26-301(1)(b)(iv)">the reasonable interest rates to be charged upon late claim payments.</subsection></subsection></subsection><subsection number="31A-26-301(2)"><subsection number="31A-26-301(2)(a)">Notwithstanding Subsection <xref depth="4" refnumber="31A-26-301(1)" start="0">(1)</xref> and subject to Subsection <xref depth="4" refnumber="31A-26-301(2)(b)" start="0">(2)(b)</xref>, the payment of a claim is not overdue during any period in which:<subsection number="31A-26-301(2)(a)(i)">the insurer is unable to pay the claim because there is no recipient legally able to give a valid release for the payment; or</subsection><subsection number="31A-26-301(2)(a)(ii)">the insurer is unable to determine who is entitled to receive the payment.</subsection></subsection><subsection number="31A-26-301(2)(b)">Subsection <xref depth="4" refnumber="31A-26-301(2)(a)" start="0">(2)(a)</xref> applies only if the insurer:<subsection number="31A-26-301(2)(b)(i)">promptly notifies the claimant of the inability to pay the claim; and</subsection><subsection number="31A-26-301(2)(b)(ii)">offers in good faith to pay the claim promptly when the inability to pay the claim is removed.</subsection></subsection></subsection><subsection number="31A-26-301(3)">This section applies only to a claim for first party benefits made by a person who is:<subsection number="31A-26-301(3)(a)">named or defined as an insured under the terms of an insurance policy;</subsection><subsection number="31A-26-301(3)(b)">described as a covered person under the terms of a policy of health care insurance as defined in Section <xref depth="3" refnumber="31A-1-301" start="0">31A-1-301</xref>; or</subsection><subsection number="31A-26-301(3)(c)">named, defined, or described:<subsection number="31A-26-301(3)(c)(i)">as:<subsection number="31A-26-301(3)(c)(i)(A)">an insured;</subsection><subsection number="31A-26-301(3)(c)(i)(B)">a beneficiary;</subsection><subsection number="31A-26-301(3)(c)(i)(C)">a policyholder; or</subsection><subsection number="31A-26-301(3)(c)(i)(D)">otherwise covered person; and</subsection></subsection><subsection number="31A-26-301(3)(c)(ii)">under the terms of:<subsection number="31A-26-301(3)(c)(ii)(A)">a life insurance policy; or</subsection><subsection number="31A-26-301(3)(c)(ii)(B)">an annuity.</subsection></subsection></subsection></subsection><subsection number="31A-26-301(4)"><subsection number="31A-26-301(4)(a)">A dental insurer that pays a claim with a tangible check shall send the tangible check to the address designated by the provider.</subsection><subsection number="31A-26-301(4)(b)">If a tangible check described in Subsection <xref depth="4" refnumber="31A-26-301(4)(a)">(4)(a)</xref> is returned to the dental insurer or has not been deposited or cashed after 180 days after the day on which the tangible check is issued, the dental insurer shall make a reasonable attempt to notify the provider by phone, mail, and email.</subsection><subsection number="31A-26-301(4)(c)">A dental insurer that complies with Subsection <xref depth="4" refnumber="31A-26-301(4)(b)">(4)(b)</xref> is not obligated to pay a claim if:<subsection number="31A-26-301(4)(c)(i)">at least 365 days after the day on which the tangible check was issued have passed;</subsection><subsection number="31A-26-301(4)(c)(ii)">the dental insurer has documented the dental insurer's attempts to notify the provider of the returned payment; and</subsection><subsection number="31A-26-301(4)(c)(iii)">the provider has not:<subsection number="31A-26-301(4)(c)(iii)(A)">attempted to collect the payment; or</subsection><subsection number="31A-26-301(4)(c)(iii)(B)">contacted the dental insurer about the payment.</subsection></subsection></subsection></subsection><subsection number="31A-26-301(5)">If a dental insurer does not pay a claim to a provider after the dental insurer complies with Subsection <xref depth="4" refnumber="31A-26-301(4)">(4)</xref>, the provider may not seek payment from the insured.</subsection></section>