210 Neb. Admin. Code, ch. 61, § 003
All definitions contained in the Unfair Insurance Claims Settlement Practices Act are hereby incorporated by reference. As otherwise used in this regulation:
"Agent" means any individual, corporation, association, partnership or other legal entity authorized to represent an insurer with respect to a claim;
"Beneficiary" means a party entitled to receive the proceeds or benefits occurring under the policy in lieu of the insured but shall not include a medical services provider receiving an assignment of proceeds;
"Claim file" means any retrievable electronic file, microfilm/microfiche file, paper file, or any combination thereof;
"Claimant" means an insured, or the beneficiary and includes a designated legal representative or a member of the insured's immediate family as designated by the insured, making a claim under a policy.
"Days" means working days;
"Documentation" includes, but is not limited to, all pertinent communications, transactions, notes, work papers, claim forms, bills and explanation of benefits forms relative to the claim;
"Investigation" means all activities of an insurer directly or indirectly related to the determination of liabilities under coverages afforded by an insurance policy or certificate;
"Notification of claim" means any notification by a claimant, whether in writing or by other means acceptable under the terms of an insurance policy or certificate, to an insurer or its agent which reasonably apprises the insurer of the facts pertinent to a claim;
"Proof of loss" means written proofs, such as claim forms, medical bills, or other reasonable evidence of the claim that is ordinarily required of persons submitting the claim(s);
"Reasonable explanation" means information reasonably sufficient to enable the insured or beneficiary to compare the allowable benefits with policy or certificate provisions and determine whether proper payment has been made;
"Written communications" includes all correspondence, regardless of source or type, that is related to the handling of the claim. Written communications shall be effectively communicated when placed in the mail with adequate first class postage.
210 Neb. Admin. Code, ch. 61, § 003