§ 146.4. Misrepresentation of policy provisions.
(a) An insurer or agent may not fail to fully disclose to first-party claimants pertinent benefits, coverages or other provisions of an insurance policy or insurance contract under which a claim is presented.
(b) An insurer or agent may not fail to fully disclose to first-party claimants benefits, coverages or other provisions of an insurance policy or insurance contract when the benefits, coverages or other provisions are pertinent to a claim.
(c) An insurer may not deny a claim for failure to exhibit the property without proof of demand and refusal by a claimant to do so.
(d) An insurer may not, except where there is a time limit specified in the policy, make statements—written or otherwise—requiring a claimant to give written notice of loss or proof of loss within a specified time limit and which seek to relieve the company of its obligations if a time limit is not complied with unless the failure to comply with the time limit prejudices the rights of the insurer.
(e) An insurer may not request a first-party claimant to sign a release that extends beyond the subject matter that gave rise to the claim payment.
(f) An insurer may not issue checks or drafts in partial settlement of a loss or claim under a specific coverage which checks or drafts contain language which expressly or impliedly releases the insurer or its insured from its total liability.
Source The provisions of this § 146.4 adopted December 15, 1978, effective December 16, 1978, 8 Pa.B. 3575.
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