PJC Business

PJC 102.25

DTPA/I NSURANCE C ODE

PJC 102.25 Prompt Payment of Claims Act—Violation of Insurer’s Duty to Acknowledge Notice of Claim, Commence Investigation, and Request Information after Receiving Notice of Claim (Tex. Ins. Code § 542.055) QUESTION ______ Did Don Davis fail to do any of the following acts within fifteen days of receiving notice of a claim from Paul Payne ? “Notice of claim” means any written notification that reasonably apprises the insurer of the facts relating to the claim. 1. Acknowledge receipt of the claim in writing or make a record of the date, manner, and content of the acknowledgment if it was not done in writ ing; or 2. commence investigation of the claim; or 3. request from Paul Payne all items, statements, and forms that Don Davis reasonably believed, at that time, would be required from Paul Payne . Answer “Yes” or “No.” Answer: _______________ COMMENT When to use. PJC 102.25 submits the insurer’s failure to perform three statutory duties within fifteen days of the date the insurer receives the notice of claim. The duties are to acknowledge the claim, start the investigation, and request necessary information from the claimant. Tex. Ins. Code § 542.055(a) states that “[n]ot later than the 15th day or, if the insurer is an eligible surplus lines insurer, the 30th business day after the date an insurer receives notice of a claim, the insurer shall: (1) acknowledge receipt of the claim; (2) commence any investigation of the claim; and (3) request from the claimant all items, statements, and forms that the insurer reasonably believes, at that time, will be required from the claimant.” PJC 102.25 assumes the insurer is not an “eligible surplus lines insurer” and therefore provides for a fifteen-day time period in which the insurer is required to comply. See comment below, “Extension of dead line—‘eligible surplus lines insurer,’” for changes to the question if such an insurer is involved. Broad-form submission. PJC 102.25 is a broad-form question designed to be accompanied by one or more appropriate instructions. Tex. R. Civ. P. 277 requires that “the court shall, whenever feasible, submit the cause upon broad-form questions.” Tex.

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