3 Alaska Admin. Code § 26.300

Current through October 17, 2024
Section 3 AAC 26.300 - Definitions

In this chapter,

(1) "claim" means notice that an event, act or omission has occurred which may result in injury or damage for which an insured may be legally obligated to pay;
(2) "claimant" means a first-party claimant, a third-party claimant, or both, and includes the claimant's legal representative and includes a member of the claimant's immediate family if authorized by the claimant;
(3) repealed 8/20/2016;
(4) "destination or delivery charges" means the charges for shipping a motor vehicle to a primary residence of the claimant or to where the motor vehicle is primarily operated;
(5) "first-party claimant" means a person asserting a right to payment under his or her own coverage;
(6) "frequency as to indicate a general business practice" means violation of any one standard committed on one or more percent of claims handled within a 12-month period, or the repeated violation of a single standard without reasonable explanation;
(7) "local market area" means the geographical area, in the closest proximity to the claimant's residence, in which two or more licensed dealers are located;
(8) "outside attorney" means an attorney who is in private practice and not an employee of a person transacting a business of insurance under AS 21;
(9) repealed 8/20/2016;
(10) "third-party claimant" means any person asserting a claim against any other person;
(11) repealed 9/15/2004;
(12) "working days" means all calendar days except Saturdays, Sundays, all official federal holidays, and all official Alaska holidays.
(13) "comparable motor vehicle" means a motor vehicle by the same manufacturer, of the same or newer model year, and with similar body style, similar options, and similar mileage as the loss vehicle, and in as good or better condition;
(14) "licensed," when used with reference to a dealer, supplier, or contractor, means in possession of a current business license under AS 43.70 and 12 AAC 12;
(15) "similar mileage" means having mileage that does not exceed the mileage of the loss vehicle on the date of loss by more than 4,000 miles or 10 percent of the mileage of the loss vehicle, whichever is greater.
(16) "clean claim" has the meaning given in AS 21.36.495;
(17) "electronic funds transfer" means a paperless or cardless transfer of funds initiated by an insurer to authorize a financial institution to credit a claimant's account using the insurer's funds in order to pay a judgment or settlement of a claim;
(18) "emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, that a prudent person who possesses an average knowledge of health and medicine could reasonably expect that the absence of immediate medical attention would result in serious impairment of bodily functions, serious dysfunction of a bodily organ or part, or would place the person's health or, with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy.
(19) "emergency services" means medical care services or items furnished or required to evaluate and treat an emergency medical condition;
(20) "health care insurance" has the meaning given in AS 21.12.050;
(21) "prepaid card product" means a reloadable card issued by a financial institution in the name of the claimant that is loaded with funds from an insurer to pay a judgment or settlement of a claim;
(22) "procedure code" means a universal code used by a health care provider to identify the services or supplies provided to an insured under a health care insurance policy.

3 AAC 26.300

Eff. 5/6/89, Register 110; am 4/20/97, Register 142; am 9/15/2004, Register 171; am 6/6/2015, Register 214, July 2015; am 8/20/2016, Register 219, October 2016

In 2010 the revisor of statutes, acting under AS 01.05.031, redesignated former AS 21.36.350 as AS 21.36.125(c). As of Register 196 (January 2011), the regulations attorney made a conforming technical revision under AS 44.62.125(b)(6), to the authority citation that follows 3 AAC 26.300, deleting the citation to former AS 21.36.350 to reflect that the authority citation already includes a citation to AS 21.36.125, the section where material formerly in AS 21.36.350 was relocated.

Authority:AS 21.06.090

AS 21.12.050

AS 21.36.125

AS 21.36.495