{"data":{"id":"us-va/14vac5-400-40","jurisdiction":"us-va","citation":"14VAC5-400-40","heading":"Misrepresentation of policy provisions","body":"A. No  insurer shall fail to fully disclose to a first party claimant all pertinent benefits, coverages, or other provisions  of an insurance policy under which a claim is presented and document the claim file accordingly.\n\nB. No person shall misrepresent benefits, coverages, or other provisions of any insurance policy when such benefits, coverages, or other provisions are pertinent to a claim.\n\nC. No insurer shall deny a claim for failure of a first party claimant to submit to physical examination or for failure of  the first party claimant to exhibit  property  unless there is documentation of breach of the policy provisions in the claim file.\n\nD. No insurer shall deny a claim based on the failure of a claimant to give written notice of loss  or give notice of loss within a specified period of time unless either or both requirements are policy  conditions.  If a policy requires a demonstration of prejudice for a claimant's failure to comply with a notice condition, an insurer shall not be relieved of its obligations under the policy unless the failure  to   comply with the notice condition  prejudices the insurer's rights.\n\nE. No insurer shall request a first party claimant to sign a release that extends beyond the subject matter that gave rise to the claim. An insurer shall not include with any payment or in any accompanying correspondence an indication that payment is \"final\" or \"a release\" of any claim unless the policy limit has been paid or a compromise settlement has been agreed to by the first party claimant.\n\nF. No insurer shall issue  a payment in partial settlement of a loss or claim  for a specific coverage  that contains language  purporting to release the insurer or  its insured from  total liability.","path":["Title 14. Insurance","Agency 5. State Corporation Commission, Bureau of Insurance","Chapter 400. Rules Governing Unfair Claim Settlement Practices"],"source_url":"https://law.lis.virginia.gov/admincode/title14/agency5/chapter400/section40/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:52:02Z","sha256":"e5d18511092dd6b5fb7d2f424beb4008cf314e76d4c0bd3adbcc554996189f5b","source_id":"us-va-vac","stale":false,"prev":"us-va/14vac5-400-30","next":"us-va/14vac5-400-50"},"notice":"GroundRules: Original legal text. Not legal advice."}