Section 0780-01-82-.06 - FILING OF APPEALS(1) Any person aggrieved by a decision on the merits of the appeal rendered pursuant to Rule 0780-1-82-.05, or any person that does not receive a written decision on a request for review submitted pursuant to Rule 0780-1-82-.05 within forty-five (45) days from the date the insured sends the request to review to the insurer or rate service organization, shall have the right to appeal the decision of the insurer or rate service organization to the commissioner, subject to the conditions set forth in this Chapter. The commissioner shall presume that after the expiration of forty-five days, the insurer or rate service organization has failed to act within the required thirty (30) day period provided for in T.C.A. §56-5-309(b).(2) In order to be considered, any appeal filed pursuant to this Chapter must meet the following requirements: (a) The appeal must be filed with the commissioner within thirty (30) days of either: 1. The receipt of the decision; or2. Expiration of the forty-five (45) day period provided for in Rule 0780-1-82-.06(1);(b) The appeal must contain a short and plain statement as to what portion of the decision is being appealed and the basis for such appeal;(c) The appeal must be accompanied by the written decision rendered by the insurer or rate service organization or if applicable, a written statement from the insured that a request for review was made over forty-five days (45) ago and that no response has been received;(d) The appeal should specify the date in which the insured would like to have the hearing consistent with the dates provided in Rule 0780-1-82-.07(1); and(e) The appeal must be accompanied by a certification from the insured or the insured's attorney that a copy of any materials filed with the commissioner have also been sent to the Administrative Procedures Division of the Office of the Secretary of State and all parties to the dispute.1. In sending the appeal, the insured may use any method allowed by law for legal service of process.2. The appeal to the commissioner shall be sent to the Department of Commerce and Insurance, Davy Crockett Tower, Actuarial Services Section, 4th Floor, 500 James Robertson Parkway, Nashville, Tennessee 37243.Tenn. Comp. R. & Regs. 0780-01-82-.06
Original rule filed December 11, 2007; effective February 24, 2008.Authority: T.C.A. §56-5-309(b), (c) and (d).