Ill. Admin. Code tit. 92 § 1457.415

Current through Register Vol. 48, No. 50, December 13, 2024

Section 1457.415 - Investigation of Claims

a) Upon receipt of a written claim, the processing carrier shall initiate an investigation and establish a file, as required by Section 1457.420.

b) If a carrier discovers an overcharge or duplicate payment that has not been the subject of a claim, it shall, within 10 days, initiate an investigation and comply with the provisions of Section 1457.435.

c) In the event the carrier processing the claim requires information or documentation in addition to that submitted with the claim, the carrier shall, within 10 days, notify the claimant and specify the additional information requested. This includes notifying the claimant that a written claim must be filed before the carrier becomes subject to the time limits for settling a claim under Section 1457.430.

Ill. Admin. Code tit. 92, § 1457.415