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Utah Code § 31A-21-314

Prohibited provisions

Amended by Chapter 351, 2018 General Session

(1) As used in this section:

(a) "Reserving discretionary authority" means a policy provision that:

(i) has the effect of conferring discretion on an insurer, or other claim administrator, to:

(A) determine eligibility for benefits; or

(B) interpret the terms or provisions of the policy, contract, certificate, or agreement; and

(ii) could lead to a deferential standard of review by a reviewing court.

(b) "Reserving discretionary authority" does not include a policy provision that:

(i) informs an insured that, as part of the insurer's routine operations, the insurer applies the terms of the contract for:

(A) making a decision, including making a determination regarding eligibility, or receipt of benefits or claims; or

(B) explaining the insurer's policies and procedures; and

(ii) does not give rise to a deferential standard of review by a reviewing court.

(2) An insurance policy subject to this chapter may not contain a provision:

(a) requiring the insurance policy to be construed according to the laws of another jurisdiction except as necessary to meet the requirements of compulsory insurance laws of other jurisdictions;

(b) depriving Utah courts of jurisdiction over an action against the insurer, except as provided in permissible arbitration provisions;

(c) limiting the right of action against the insurer to less than three years from the date the cause of action accrues; or

(d) for life insurance or accident and health insurance, reserving discretionary authority.

(3) For purposes of Subsection (2)(c), the cause of action accrues on a fidelity bond on the date the insurer first denies all or part of a claim made under the fidelity bond.

Official source: Utah State Legislature. Reproduced from public-domain Utah statutes; confirm against the official source for the current text. Not legal advice.