An accident and sickness claim is submitted with written proof of loss, and the prescription drug claims were paid through an out-of-state pharmacy network. Under Va. Code § 38.2-3407.1, when does claim-payment interest begin to accrue for this claim?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Va. Code § 38.2-3407.1 sets the standard rule — claim interest at the legal rate from the 15th working day after receipt of proof of loss — but carves out claims that come through an out-of-state pharmacy network, for which interest begins from the 30th day after the insurer receives the proof of loss. The carve-out recognizes the longer settlement pipeline created by out-of-state pharmacy payment systems. Recognizing which trigger applies matters because the two dates produce different interest obligations, and the Virginia Bureau of Insurance enforces the statute as written for each claim type.
Why the other options are wrong
- A) The 15th-working-day rule is the general one; the out-of-state pharmacy-network claim uses the special 30th-day trigger.
- B) The statute keys the special trigger to receipt of proof of loss, not to when the pharmacy network processed the claim.
- D) The policy's effective date is irrelevant to claim interest; both triggers run from receipt of proof of loss.
Memory hook
Out-of-state pharmacy claims get a longer fuse: interest starts at day 30, not 15.