No Private Right of Action Under Prompt Pay Law

The Nevada Supreme Court examined Nevada’s so-called “prompt-pay” statute, NRS 690B.012, in a decision dated November 21, 2007. See, Allstate Ins. Co. v. Thorpe, 123 Nev. Adv. Op. No. 52.

That statute “requires casualty insurers to approve and pay, or deny, casualty claims, including claims for medical payment benefits, within a limited time frame. Under the statute, an insurer must pay interest on any untimely claims payments.”

In the appeal before them, “the Court considered whether NRS 690B.012 grants private rights of action to medical services providers who administer care to persons insured under contracts of “casualty insurance,”[2] so that the medical services providers may sue the person’s insurer, if that insurer fails to promptly pay claims.”

The Court held that “NRS 690B.012 does not expressly create a private right of action in favor of an insured’s medical provider to sue an insurer who fails to make prompt payments to the insured or the insured’s medical providers. Instead, the statutory scheme contemplates an exclusive administrative procedure for resolving claims concerning alleged violations of NRS 690B.012, under which those persons with a direct and immediate pecuniary interest in prompt payment may proceed. We therefore conclude that (1) there is no private right of action in the district court under the statute, but (2) medical providers, as persons with a direct and immediate pecuniary interest in the prompt payment of medical payment benefits, may seek administrative remedies before the Nevada Department of Insurance (NDOI), subject to judicial review under the Nevada Administrative Procedure Act.”