210 Neb. Admin. Code, ch. 60, § 004

Current through September 17, 2024
Section 210-60-004 - File and record documentation

Each insurer's claim files are subject to examination by the Director of Insurance or by the Director's duly appointed designees. To aid in such examination:

004.01 The insurer shall maintain claim data that is accessible and retrievable for examination. An insurer shall be able to provide the claim number, line of coverage, date of loss and date of payment of the claim, date of denial or date closed without payment. This data must be available for all open and closed files for the current year and the two preceding years.
004.02 Detailed documentation shall be contained in each claim file in order to permit reconstruction of the insurer's activities relative to each claim.
004.03 Each relevant document within the claim file shall be noted as to date received, date processed or date mailed.
004.04 For those insurers that do not maintain hard copy files, claim files must be accessible from Cathode Ray Tube (CRT), Video Display Terminal (VDT) or micrographics and be capable of duplication to hard copy.

210 Neb. Admin. Code, ch. 60, § 004