Section 0780-01-05-.05 - FILE AND RECORD DOCUMENTATIONEach insurer's claim files for policies or certificates are subject to examination by the commissioner or his or her duly appointed designees. To aid in such examination:
(1) 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, date of payment of the claim, date of denial or date closed without payment. This data must be available for all open and closed claim files for the current year and the five (5) preceding years.(2) Documentation shall be contained in each claim file in order to permit reconstruction of the insurer's activities relative to each claim.(3) Each relevant document within the claim file shall be noted as to date received, date processed, or date mailed.(4) For those insurers that do not maintain hard copy files, claim files must be accessible from cathode ray tube (CRT), micrographics, magnetic tape, electronic databases, or other electronic storage formats, and be capable of duplication to hard copy.Tenn. Comp. R. & Regs. 0780-01-05-.05
Original rules filed July 11, 2017; effective 10/9/2017.Authority: T.C.A. §§ 56-1-103, 56-1-106, 56-1-408, 56-1-409, 56-1-410, 56-2-301, 56-8-101 through 56-8-120, 56-8-104(10), 56-8-107, 56-8-108, and 56-8-110.