Which of the following is an example of an unfair claims settlement practice?

Prepare for the Georgia Health Insurance Exam. Study using flashcards, multiple-choice questions, and get ready with explanations for each question. Ace your exam!

Turning down a claim without providing the basis of denial is an example of an unfair claims settlement practice because it violates the principles of transparency and fairness in the insurer's obligations to the policyholder. When an insurance company denies a claim, it is required to inform the policyholder of the specific reasons for the denial. This allows the insured to understand the decision and assess whether they wish to appeal it or seek further clarification. By failing to provide this information, the insurer may leave the policyholder feeling confused and powerless, undermining trust in the claims process and potentially leading to financial harm if the insured is unaware of their rights or the grounds for denial.

In contrast, while delaying payment without explanation is also problematic and can be seen as poor practice, offering less than the policy limit can be acceptable under specific circumstances if the claim is partially valid. Not providing a coverage limit, although concerning, is more a problem related to clarity of the policy rather than a claim settlement practice. Each of these options reflects different aspects and obligations within the insurance claims process, but the lack of a clear reason for denial stands out as a critical failure to uphold fair treatment of policyholders.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy