<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s29990739-75cc-4951-8cd1-e911c12124f1Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000000 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000002 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s29990739-75cc-4951-8cd1-e911c12124f1000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Rules?Rule=20:06:21:01.06"><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000000">20:06:21:01.06</span></a><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000001">.  Claim and clean claim -- Defined.</span><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont"> For purposes of §§ </span><a href="https://sdlegislature.gov/Rules?Rule=20:06:21:104"><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000002">20:06:21:104</span></a><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Rules?Rule=20:06:21:108"><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000002">20:06:21:108</span></a><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">, inclusive, terms used mean:</span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1000003"> </span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">    (1)  "Claim," a request for payment of benefits under an in-force policy, regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met;</span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1000003"> </span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">    (2)  "Clean claim," a claim that has no defect or impropriety, including any lack of required substantiating documentation, such as satisfactory evidence of expenses incurred, or particular circumstance requiring special treatment that prevents timely payment from being made on the claim.</span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1000003"> </span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">    </span><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000001">Source:</span><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont"> 36 SDR 209, effective July 1, 2010.</span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">    </span><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000001">General Authority:</span><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17B-4"><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000002">58-17B-4</span></a><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">.</span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">    </span><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000001">Law Implemented:</span><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17B-4"><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont-000002">58-17B-4</span></a><span class="s29990739-75cc-4951-8cd1-e911c12124f1DefaultParagraphFont">.</span></p><p dir="ltr" class="s29990739-75cc-4951-8cd1-e911c12124f1Normal"><span xml:space="preserve" class="s29990739-75cc-4951-8cd1-e911c12124f1000003"> </span></p></div></body></html>