{"data":{"id":"us-md/md.-code-insurance-27-304","jurisdiction":"us-md","citation":"Md. Code, Insurance § 27–304","heading":"","body":"It is an unfair claim settlement practice and a violation of this subtitle for an insurer, nonprofit health service plan, or health maintenance organization, when committed with the frequency to indicate a general business practice, to:\n(1) misrepresent pertinent facts or policy provisions that relate to the claim or coverage at issue;\n(2) fail to acknowledge and act with reasonable promptness on communications about claims that arise under policies;\n(3) fail to adopt and implement reasonable standards for the prompt investigation of claims that arise under policies;\n(4) refuse to pay a claim without conducting a reasonable investigation based on all available information;\n(5) fail to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed;\n(6) fail to make a prompt, fair, and equitable good faith attempt, to settle claims for which liability has become reasonably clear;\n(7) compel insureds to institute litigation to recover amounts due under policies by offering substantially less than the amounts ultimately recovered in actions brought by the insureds;\n(8) attempt to settle a claim for less than the amount to which a reasonable person would expect to be entitled after studying written or printed advertising material accompanying, or made part of, an application;\n(9) attempt to settle a claim based on an application that is altered without notice to, or the knowledge or consent of, the insured;\n(10) fail to include with each claim paid to an insured or beneficiary a statement of the coverage under which the payment is being made;\n(11) make known to insureds or claimants a policy of appealing from arbitration awards in order to compel insureds or claimants to accept a settlement or compromise less than the amount awarded in arbitration;\n(12) delay an investigation or payment of a claim by requiring a claimant or a claimant’s licensed health care provider to submit a preliminary claim report and subsequently to submit formal proof of loss forms that contain substantially the same information;\n(13) fail to settle a claim promptly whenever liability is reasonably clear under one part of a policy, in order to influence settlements under other parts of the policy;\n(14) fail to provide promptly a reasonable explanation of the basis for denial of a claim or the offer of a compromise settlement;\n(15) refuse to pay a claim for an arbitrary or capricious reason based on all available information;\n(16) fail to meet the requirements of Title 15, Subtitle 10B of this article for preauthorization for a health care service;\n(17) fail to comply with the provisions of Title 15, Subtitle 10A of this article; or\n(18) fail to act in good faith, as defined under § 27–1001 of this title, in settling a first–party claim under a policy of property and casualty insurance.","path":["Article - Insurance"],"source_url":"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin\u0026section=27-304","current_through":"2026-01-01","vintage":"","retrieved_at":"2026-09-14T19:59:28Z","sha256":"3183d6b81b191ee5f4a8806020fcd893ebe2f7c8262709119408934538c4206c","source_id":"us-md","stale":false,"prev":"us-md/md.-code-insurance-27-303","next":"us-md/md.-code-insurance-27-304.1"},"notice":"GroundRules: Original legal text. Not legal advice."}