<HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS 58-17D STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY</Div> INSURERS </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-17D STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY</Div> INSURERS "> <META NAME="Description" Content="South Dakota Codified Laws 58-17D"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: HG4 --><Div align="center"><!-- WP Style End: HG4 --> CHAPTER 58-17D <!-- WP Paired Style Off: HG4 --><!-- WP Style End: HG4 --> </Div> <br> <!-- WP Paired Style On: HG4C --><Div align="center"><!-- WP Style End: HG4C --> STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY</Div> INSURERS <!-- WP Paired Style Off: HG4C --><!-- WP Style End: HG4C --> <br> <p> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-1">58-17D-1</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Definitions. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-2">58-17D-2</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Certain utilization review organizations exempt from managed health care provisions. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-3">58-17D-3</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Property and casualty insurers to use registered utilization review organizations. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-4">58-17D-4</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Utilization review to be administered by qualified professional. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-5">58-17D-5</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Certain basis for fees prohibited. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-6">58-17D-6</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Insurer denying policyholder's claim to provide for reconsideration. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-17D-7">58-17D-7</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> No cause of action created or abrogated. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075147Normal { 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.s2075147SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075147CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075147Normal-000000 { text-indent: 0.50in; 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.s2075147DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075147Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075147000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075147SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075147SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075147Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17D-1"><span class="s2075147SENU">58-17D-1</span></a><span xml:space="preserve" class="s2075147SENU">. </span><span class="s2075147CL">Definitions.</span></p><p dir="ltr" class="s2075147Normal-000000"><span class="s2075147DefaultParagraphFont">Terms used in this chapter mean:</span></p><p dir="ltr" class="s2075147Normal-000001"><span class="s2075147DefaultParagraphFont">(1)    "Utilization review," a review of health care services provided or to be provided to an individual to assist in the determination of the nature of the injury or condition, or the appropriateness of the treatment provided or to be provided;</span></p><p dir="ltr" class="s2075147Normal-000001"><span class="s2075147DefaultParagraphFont">(2)    "Utilization review organization," any entity that provides utilization review services as defined in this chapter.</span></p><p dir="ltr" class="s2075147Normal"><span xml:space="preserve" class="s2075147000002"> </span></p><p dir="ltr" class="s2075147Normal"><span class="s2075147SCL">Source:</span><span xml:space="preserve" class="s2075147SCL-000003"> SL 2002, ch 231, § 1.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s9349792191f14ba6943382fbe9be22c2Normal { 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.s9349792191f14ba6943382fbe9be22c2SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s9349792191f14ba6943382fbe9be22c2CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s9349792191f14ba6943382fbe9be22c2Normal-000000 { text-indent: 0.50in; 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.s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s9349792191f14ba6943382fbe9be22c2000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s9349792191f14ba6943382fbe9be22c2SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s9349792191f14ba6943382fbe9be22c2SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-17D-2 - Certain utilization review organizations exempt from managed health care provisions."><meta property="og:description" content="SDLRC Codified Law 58-17D-2 - Certain utilization review organizations exempt from managed health care provisions."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes/58-17D-2"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s9349792191f14ba6943382fbe9be22c2Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-17D-2" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2SENU">58-17D-2</span></a><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2SENU">. </span><span class="s9349792191f14ba6943382fbe9be22c2CL">Certain utilization review organizations exempt from managed health care provisions.</span></p><p dir="ltr" class="s9349792191f14ba6943382fbe9be22c2Normal-000000"><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">A utilization review organization that conducts utilization reviews solely for property and casualty insurers in this state pursuant to policies issued in this state is not subject to chapters </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17F" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">58-17F</span></a><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17G" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">58-17G</span></a><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17H" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">58-17H</span></a><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">, and </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17I" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">58-17I</span></a><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont"> except that any such utilization review organization shall register in the same manner as prescribed for utilization review organizations pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17H-35" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">58-17H-35</span></a><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17H-39" rel="noopener"><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">58-17H-39</span></a><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">, inclusive. (SL 2012, ch 239, § 1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed.")</span></p><p dir="ltr" class="s9349792191f14ba6943382fbe9be22c2Normal"><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2000001"> </span></p><p dir="ltr" class="s9349792191f14ba6943382fbe9be22c2Normal"><span class="s9349792191f14ba6943382fbe9be22c2SCL">Source:</span><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2SCL-000002"> SL 2002, ch 231, § 2; SL 2011, ch 219, § 97.</span></p><p dir="ltr" class="s9349792191f14ba6943382fbe9be22c2Normal"><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2000001"> </span></p><p dir="ltr" class="s9349792191f14ba6943382fbe9be22c2Normal"><span xml:space="preserve" class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont-000003">Commission Note: </span><span class="s9349792191f14ba6943382fbe9be22c2DefaultParagraphFont">SL 2012, ch 239, § 1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed."</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075149Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075149SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075149CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075149Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075149DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075149000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075149SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075149SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075149Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17D-3"><span class="s2075149SENU">58-17D-3</span></a><span xml:space="preserve" class="s2075149SENU">. </span><span class="s2075149CL">Property and casualty insurers to use registered utilization review organizations.</span></p><p dir="ltr" class="s2075149Normal-000000"><span class="s2075149DefaultParagraphFont">Any property and casualty insurer seeking utilization review with respect to an insurance contract issued in this state may only use a utilization review organization registered pursuant to this chapter.</span></p><p dir="ltr" class="s2075149Normal"><span xml:space="preserve" class="s2075149000001"> </span></p><p dir="ltr" class="s2075149Normal"><span class="s2075149SCL">Source:</span><span xml:space="preserve" class="s2075149SCL-000002"> SL 2002, ch 231, § 3.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075150Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075150SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075150CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075150Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075150DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075150000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075150SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075150SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075150Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17D-4"><span class="s2075150SENU">58-17D-4</span></a><span xml:space="preserve" class="s2075150SENU">. </span><span class="s2075150CL">Utilization review to be administered by qualified professional.</span></p><p dir="ltr" class="s2075150Normal-000000"><span class="s2075150DefaultParagraphFont">Any utilization review pursuant to this chapter shall be administered by a qualified licensed health care professional. Any adverse determination shall be evaluated by an appropriately licensed and clinically qualified health care professional. Any utilization review evaluation shall use generally accepted standards for treatment of the illness, injury, or condition reviewed. Any utilization review opinion shall be signed by the professional who performed the review.</span></p><p dir="ltr" class="s2075150Normal"><span xml:space="preserve" class="s2075150000001"> </span></p><p dir="ltr" class="s2075150Normal"><span class="s2075150SCL">Source:</span><span xml:space="preserve" class="s2075150SCL-000002"> SL 2002, ch 231, § 4.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075151Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075151SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075151CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075151Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075151DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075151000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075151SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075151SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075151Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17D-5"><span class="s2075151SENU">58-17D-5</span></a><span xml:space="preserve" class="s2075151SENU">. </span><span class="s2075151CL">Certain basis for fees prohibited.</span></p><p dir="ltr" class="s2075151Normal-000000"><span class="s2075151DefaultParagraphFont">No utilization review organization may base its fees or charges on any recommendation for reduction in payment under an insurance contract or on a percentage of claim savings.</span></p><p dir="ltr" class="s2075151Normal"><span xml:space="preserve" class="s2075151000001"> </span></p><p dir="ltr" class="s2075151Normal"><span class="s2075151SCL">Source:</span><span xml:space="preserve" class="s2075151SCL-000002"> SL 2002, ch 231, § 5.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075152Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075152SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075152CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075152Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075152DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075152000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075152SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075152SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075152Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17D-6"><span class="s2075152SENU">58-17D-6</span></a><span xml:space="preserve" class="s2075152SENU">. </span><span class="s2075152CL">Insurer denying policyholder's claim to provide for reconsideration.</span></p><p dir="ltr" class="s2075152Normal-000000"><span class="s2075152DefaultParagraphFont">An insurer that denies, in whole or in part, a policyholder's claim after consideration of a utilization review shall provide the policyholder with an opportunity to request reconsideration and to submit additional information relating to the claim.</span></p><p dir="ltr" class="s2075152Normal"><span xml:space="preserve" class="s2075152000001"> </span></p><p dir="ltr" class="s2075152Normal"><span class="s2075152SCL">Source:</span><span xml:space="preserve" class="s2075152SCL-000002"> SL 2002, ch 231, § 6.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-17D - STANDARDS FOR UTILIZATION REVIEW FOR PROPERTY AND CASUALTY INSURERS </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075153Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075153SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075153CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075153Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075153DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075153000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075153SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075153SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style></head><body><div><p dir="ltr" class="s2075153Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17D-7"><span class="s2075153SENU">58-17D-7</span></a><span xml:space="preserve" class="s2075153SENU">. </span><span class="s2075153CL">No cause of action created or abrogated.</span></p><p dir="ltr" class="s2075153Normal-000000"><span class="s2075153DefaultParagraphFont">Nothing in this chapter is intended to create or abrogate any cause of action as a result of a violation of the standards in this chapter.</span></p><p dir="ltr" class="s2075153Normal"><span xml:space="preserve" class="s2075153000001"> </span></p><p dir="ltr" class="s2075153Normal"><span class="s2075153SCL">Source:</span><span xml:space="preserve" class="s2075153SCL-000002"> SL 2002, ch 231, § 7.</span></p></div></body></html>