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Download Rule 47:03:05:06 in Microsoft Word Format Printer Friendly

          47:03:05:06.  Dispute resolution. A person or entity aggrieved by the action of an insurer regarding medical fees must exhaust the dispute resolution procedure of the insurer before filing a petition or otherwise seeking relief from the department. If the aggrieved party has exhausted the dispute resolution procedure of the insurer or the insurer has failed to resolve a dispute within 30 calendar days after the dispute was submitted to the insurer, the party may petition the department for a hearing on the matter in dispute pursuant to SDCL chapter 1-26. The petition for a hearing must be mailed within 30 calendar days after written notice of the final decision of the insurer is mailed to the aggrieved party.


          Source: 21 SDR 67, effective October 13, 1994.

          General Authority: SDCL 62-7-8.

          Law Implemented: SDCL 62-7-8.


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