Minnesota Statutes 72A.201: Regulation of Claims Practices

Vocabulary and statutory standards for claim handling and settlement practices under Minnesota law.

Adjuster

As defined in section 72B.02.

Agent

Insurance agents or insurance agencies licensed pursuant to sections 60K.30 to 60K.56, and representatives of these agents or agencies.

Claim

A request or demand made with an insurer for the payment of funds or the provision of services under the terms of any policy, certificate, contract of insurance, binder, or other contracts of temporary insurance, excluding health insurance claims made by participating providers under specific service agreements.

Claim settlement

All activities of an insurer related directly or indirectly to the determination of the extent of liabilities due or potentially due under coverages afforded by the policy, resulting in payment, acceptance, compromise, or other disposition.

Claimant

Any individual, corporation, association, partnership, or other legal entity asserting a claim against an entity insured under an insurance policy or contract of an insurer.

Complaint

A communication primarily expressing a grievance.

Insurance policy

Any evidence of coverage issued by an insurer including policies, contracts, certificates, riders, binders, and endorsements, as well as contracts issuing coverage under self-insurance plans.

Insured

An individual or legal entity asserting a right to payment under their insurance policy arising out of the occurrence of the contingency or loss, excluding persons who acquire rights under a mortgage.

Insurer

Includes individuals, corporations, associations, partnerships, reciprocal exchanges, Lloyds, fraternal benefits societies, self-insurers, surplus line insurers, self-insurance administrators, and nonprofit service plans under Department of Commerce jurisdiction.

Investigation

A reasonable procedure adopted by an insurer to determine whether to accept or reject a claim.

Notification of claim

Any communication to an insurer by a claimant or an insured which reasonably apprises the insurer of a claim brought under an insurance contract or policy; notice to an agent is notice to the insurer.

Proof of loss

The necessary documentation required from the insured to establish entitlement to payment under a policy.

Self-insurance administrator

Any vendor of risk management services or entities administering self-insurance plans, licensed pursuant to section 60A.23, subdivision 8.

Claim Acknowledgement Timeline

Insurers must acknowledge receipt of a claim within 10 business days and provide necessary claim forms unless the claim is settled within that time.

Claim Communication Response Timeline

Insurers must reply to other communications about a claim that reasonably indicate a response is needed within 10 business days of receipt.

Investigation Completion Timeline

Insurers must complete their investigation and inform the insured of acceptance or denial within 30 business days after receipt of notification of claim.

Statute of Limitations Advisory

Insurers must advise an unresolved claimant in writing of the expiration of a statute of limitations at least 60 days prior to expiration (if communication occurred within the previous 2 years).

Denial Notification Requirement

Insurers must advise the insured of acceptance or denial within 60 business days after receipt of a properly executed proof of loss.

Settlement Payment Timeline

Insurers must issue payment for any amount finally agreed upon within 5 business days from the receipt of the agreement or performance of conditions.

Automobile Total Loss Settlement Methods

Insurers must offer either a comparable and available replacement automobile with all taxes and fees paid or a cash settlement based on the actual cost of purchase of a comparable automobile.

Automobile Damage Inspection Timeline

The insurer must exercise the right to inspect damage within 5 business days if the vehicle cannot be safely driven, or 15 days in other cases.

Legal Right to Choose Repair Shop Advisory

The mandatory statement provided to insureds: 'You have the legal right to choose a repair shop to fix your vehicle. Your policy will cover the reasonable costs of repairing your vehicle to its pre-accident condition no matter where you have repairs made.'

Complaint File Maintenance

A complaint file must be maintained for at least four years after the date of the complaint.

Commissioner Inquiry Response Timeline

Insurers must respond to an inquiry from the commissioner about a claim within 15 working days after receipt.

Section 72A.201 Scope Exclusion

This section does not apply to workers' compensation insurance.

Mandatory Disclosure Timeline

An insurer must disclose the coverage and limits of an insurance policy within 30 days after a written request by a claimant.