S.D. Admin. R. 20:06:21:01.06

Current through Register Vol. 51, page 67, December 16, 2024

Section 20:06:21:01.06 - Claim and clean claim - Defined

For purposes of §§ 20:06:21:104 to 20:06:21:108, inclusive, terms used mean:

(1) "Claim," a request for payment of benefits under an in-force policy, regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met;

(2) "Clean claim," a claim that has no defect or impropriety, including any lack of required substantiating documentation, such as satisfactory evidence of expenses incurred, or particular circumstance requiring special treatment that prevents timely payment from being made on the claim.

S.D. Admin. R. 20:06:21:01.06

36 SDR 209, effective 7/1/2010.

General Authority: SDCL 58-17B-4.

Law Implemented: SDCL 58-17B-4.