{"data":{"id":"us-ky/krs-304.12-230","jurisdiction":"us-ky","citation":"KRS 304.12-230","heading":"Unfair claims settlement practices.","body":"It is an unfair claims settlement practice for any person to commit or perform any of the\nfollowing acts or omissions:\n(1) Misrepresenting pertinent facts or insurance policy provisions relating to coverages\nat issue;\n(2) Failing to acknowledge and act rea sonably promptly upon communications with\nrespect to claims arising under insurance policies;\n(3) Failing to adopt and implement reasonable standards for the prompt investigation of\nclaims arising under insurance policies;\n(4) Refusing to pay claims withou t conducting a reasonable investigation based upon\nall available information;\n(5) Failing to affirm or deny coverage of claims within a reasonable time after proof of\nloss statements have been completed;\n(6) Not attempting in good faith to effectuate promp t, fair and equitable settlements of\nclaims in which liability has become reasonably clear;\n(7) Compelling insureds to institute litigation to recover amounts due under an\ninsurance policy by offering substantially less than the amounts ultimately\nrecovered in actions brought by such insureds;\n(8) Attempting to settle a claim for less than the amount to which a reasonable man\nwould have believed he was entitled by reference to written or printed advertising\nmaterial accompanying or made part of an application;\n(9) Attempting to settle claims on the basis of an application which was altered without\nnotice to, or knowledge or consent of the insured;\n(10) Making claims payments to insureds or beneficiaries not accompanied by statement\nsetting forth the coverage under which the payments are being made;\n(11) Making known to insureds or claimants a policy of appealing from arbitration\nawards in favor of insureds or claimants for the purpose of compelling them to\naccept settlements or compromises less than the amount awarded in arbitration;\n(12) Delaying the investigation or payment of claims by requiring an insured, claimant,\nor the physician of either to submit a preliminary claim report and then requiring the\nsubsequent submission of formal proof of loss forms, bo th of which submissions\ncontain substantially the same information;\n(13) Failing to promptly settle claims, where liability has become reasonably clear, under\none (1) portion of the insurance policy coverage in order to influence settlements\nunder other portions of the insurance policy coverage;\n(14) Failing to promptly provide a reasonable explanation of the basis in the insurance\npolicy in relation to the facts or applicable law for denial of a claim or for the offer\nof a compromise settlement;\n(15) Failing to comply with the decision of an independent review entity to provide\ncoverage for a covered person as a result of an external review in accordance with\nKRS 304.17A-621, 304.17A-623, and 304.17A-625;\n(16) Knowingly and willfully failing to comply with the provisions of KRS 304.17A-714\nwhen collecting claim overpayments from providers; or\n(17) Knowingly and willfully failing to comply with the provisions of KRS 304.17A-708\non resolution of payment errors and retroactive denial of claims.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=17037","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:42Z","sha256":"5d09f356934a1e078a3cd8f00b744c7218c67c400588d8bebfd9076e9b18d58c","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.12-220","next":"us-ky/krs-304.12-235"},"notice":"GroundRules: Original legal text. Not legal advice."}