Definitions regarding standards for claims processing.

Checkout our iOS App for a better way to browser and research.

58-12-31. Definitions regarding standards for claims processing.

Terms used in §§58-12-31 to 58-12-37, inclusive, mean:

(1)"Director," the director of the South Dakota Division of Insurance;

(2)"Insured," the party named on a policy or certificate as the individual with legal rights to the benefits provided by the policy;

(3)"Insurer," a person, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society, and any other legal entity engaged in the business of insurance, including claim agents, brokers, adjusters, and third party administrators. The term also includes medical service plans, hospital service plans, health maintenance organizations, prepaid limited health care service plans, dental plans, and optometric plans. This term does not include any insurance producer licensed pursuant to chapter 58-30, unless an insurance producer is directly involved in the adjudication of claims;

(4)"Person," a natural or artificial entity, including individuals, partnerships, associations, trusts, or corporations;

(5)"Policy," or "certificate," a contract of insurance, indemnity, medical, health, or hospital service, or annuity issued. The term does not include contracts of workers' compensation, fidelity, suretyship, or boiler and machinery insurance.

Source: SL 2014, ch 235, §1.


Download our app to see the most-to-date content.