Kentucky Health Insurance Practice Exam

After receiving proof of loss, how long does an insurer have to begin any necessary investigation?

1. 15 days

2. 30 days

3. 60 days

4. 90 days

The correct answer is: 15 days

Once an insurer receives proof of loss, they are required to begin any necessary investigation within 15 days. This timeframe is established to ensure that claims are processed promptly and fairly. The rationale behind this regulation is to promote timely responses by insurers and to facilitate a smoother claims process for policyholders. By initiating investigations quickly, insurers can gather all necessary information and evidence while events are still fresh, which often aids in a more accurate resolution of claims. The other timeframes provided in the options are longer than the mandated period. While each insurer may set internal policies for their processes, regulatory standards require action to be taken within the 15-day limit to ensure accountability and efficiency in addressing claims.