Title 33, Chapter 20, Section 27
( 33-20-27)
(a) The Commissioner may after a hearing impose upon a health care
corporation an administrative fine if he finds that the corporation
through the acts of its officers, employees, agents, or
representatives has with such frequency as to indicate its general
business practice in this state: (1) Refused without just cause to pay proper claims arising under
coverage provided by its contracts whether the claim is in favor
of a subscriber or in favor of any other person entitled to the
proceeds of a contract; or (2) Compelled without just cause subscribers, claimants, or other
persons entitled to the proceeds of its contracts in this state to
accept less than the amount due them or to bring action against
the corporation to secure full payment or settlement of their
claims. (b) The administrative fine imposed for violations set forth in
paragraph (1) or (2) of subsection (a) of this Code section shall
not exceed $1,000.00 for each act of misconduct constituting a
violation; provided, however, that a fine of not more than $5,000.00
for each act of willful misconduct constituting a violation may be
imposed. |