Kontosis Case Conceptualization Paper

In her appeal, Kontosis challenges the MIA’s determination the Hartford had not engaged in an unfair claims settlement practice. In support of her argument, Kontosis contends that it was an unfair claims settlement practice for Hartford to classify benefits received from the group policy and SSDI as other income under the association policy. Additionally, Kontosis alleges that it was an unfair claims settlement practice to seek reimbursement for the overpayment Hartford made as a result of not applying offsets under the association policy for the period that Hartford was not paying benefits under the group policy. Finally, Kontosis avers that the MIA erred when it determined that Md. Code (1995, 2011 Repl. Vol., 2015 Suppl.), § 15-501 of the Insurance Article (“INS”) was inapplicable to this case. We shall address these arguments in turn. Subtitle three of title 27 of the insurance article of the Maryland Code prohibits insurers from engaging in unfair claim settlement practices, and affords claimants an administrative remedy for those who are aggrieved by an insurer’s unfair claim settlement practice. INS § 27-301. Indeed, under title 27 of the insurance article:
It is an unfair claim settlement practice and a violation of …show more content…
BLACK'S LAW DICTIONARY 55 (Abridged 5th Ed.1983). The word “capricious” is used to describe a refusal to pay a claim based on an unpredictable whim. WEBSTER’S at 227. Thus, under [INS] § 27-303, an insurer may properly deny a claim if the insurer has an otherwise lawful principle or standard which it applies across the board to all claimants and pursuant to which the insurer has acted reasonably or rationally based on “all available