§ 58-67-135. Incurred but not reported claims.
§58‑67‑135. Incurred but not reported claims.
(a) Every HMO shall,when determining liability, include an amount estimated in the aggregate toprovide for any unearned premium and for the payment of all claims for healthcare expenditures that have been incurred, whether reported or unreported, thatare unpaid and for which such HMO is or may be liable; and to provide for theexpense of adjustment or settlement of such claims.
(b) Such liabilitiesshall be computed in accordance with rules adopted by the Commissioner uponreasonable consideration of the ascertained experience and character of theHMO. (1989, c. 776, s. 13.)