I recently received a request for a blog on the claims handling requirements for Missouri. I always aim to please, so here are the requirements for an insurer handling claims in the Show Me state.
A Missouri insurance carrier must acknowledge receipt of a claim within 10 working days of receipt of the claim. Mo. Code Regs. Ann. 20 § 100-1.030(1). They must also provide all claims forms and instructions for their use in response to a request within 15 days from the date of the request. Mo. Code Regs. Ann. 20 § 100-1.030(3). They must respond to all communications from a claimant (where a response is reasonably required) within 10 working days. Mo. Code Regs. Ann. 20 § 100-1.030(2). The insurance carrier must affirm or deny coverage of the claim or advise that further information is needed within 15 days after they have received all forms and documents necessary to establish the nature of the claim. Mo. Code Regs. Ann. 20 § 100-1.050(1)(A)&(C). The carrier must update the claimant on the status of the claim investigation every 45 days. Mo. Code Regs. Ann. 20 § 100-1.050(1)(C).
When dealing with a first party claimant, the carrier must give notice 30 days before a statute of limitations or other deadline would expire. Mo. Code Regs. Ann. 20 § 100-1.050(1)(E). Interestingly, this portion of the regulation specifically states that notice must be given 30 days before the expiration of the date, it does not say it can be given at any time before that. In other words, the carrier cannot give notice of the statute of limitations in their first communication and then be absolved from giving notice again as the date approaches. Finally, an insurer cannot deny or withhold payment of a claim on the basis that another party should be responsible. Mo. Code Regs. Ann. 20 § 100-1.050(1)(D). Thus the carrier must pay the claim and pursue the potential third party in subrogation.
While I plan to touch on all fifty states, if you have a burning desire to see a state covered sooner rather than later, please send us the request! Finally, in doing my research for this post, I happily discovered that one of the songs I remember my sister playing on the piano as a child was written in St. Louis, Missouri: