State RegulationsNC specificDifficulty 2/5
An insurer receives a health claim but neither pays, denies, nor requests information within the period required by the prompt-pay statute. What interest obligation applies to the late-paid amount?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under G.S. 58-3-225(b) and (e), the insurer must pay, deny, or request information within 30 calendar days of receiving a claim, and any late payment bears interest at 18% per annum. A claim is presumed received 5 business days after mailing or electronic transmission, so the clock rarely waits for the insurer's mailroom.
Why the other options are wrong
- A) The prompt-pay statute attaches an 18% per annum interest obligation to late payment; eventual full payment does not erase it.
- C) The deposit-rate interest rule is the death benefit provision of G.S. 58-58-110(a); health claims carry the 18% rate under G.S. 58-3-225(e).
- D) The interest obligation is statutory under G.S. 58-3-225(e) and does not depend on a written demand from the claimant.
Memory hook
Slow to pay a health claim? The statute charges 18 percent a year.