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A06286
and
S2816A |
A bill that makes it harder for accident victims and their doctors to be paid, and easier for carrier’s to avoid payment. Insurance company does not have to tell you why the claim is not being paid, and can come up with new reasons at any time. Restricts patient's rights to assign benefits. Requires patients to pay for some treatment out of pocket. Shifts the burden of proof away from the carrier and onto the doctors. Denies access to the courthouse. Gives the Insurance Department (not the Health Department) the sole practically unfettered right to prohibit a doctor from receiving payment (even for treatment already rendered). Establishes mandatory treatment guidelines. |
morellej@assembly.state.ny.us
seward@senate.state.ny.us
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A3787
and
S3444
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Enacts the Automobile Insurance Fraud Prevention Act of 2011. Lifts the preclusion penalty as it relates to evidence that the services were not rendered or the billing exceeded the fee limitations by more than 10%. Improves arbitration by requiring arbitrators to consider substantive law, expanding the right to appeal, limiting the collateral estopple effect of decisions, and removing the prohibition against resolving separate disputes from the same accident in alternative forums. Provides simplified evidentiary rules for the trial of overdue no-fault claim. Expands the definition of serious physical injury. Provides for coverage for innocent victims of intentional "accidents". Expands the Insurance Department’s ability to prohibit providers from treating accident victims if there has been a finding of wrongdoing.
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NYFAIR's
position |
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Program Bill 288 |
An Act to eliminate the preclusion penalty; limit access to the courthouse; and fine and "decertify" providers of health care services.
( memo in support) |
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Provides that
payment of interest payment and attorney fees to claimant
when payment of a
claim is overdue shall be exclusive remedy when insurer fails
to make timely
payment; such failure of insurer to make timely payment or
issue denial within 30
days after proof of claim has been submitted to insurer
shall not preclude
such insurer from issuing a denial or asserting a defense
after the 30 day
period has elapsed. |
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Pending |
A proposed law that would allow insurance carriers to deny medical
claims with only written documents of experts, and take away the
fundamental right of medical providers to cross-examine those experts in
court. |
Pending |
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Enacts the
"automobile insurance consumer information act"; provides for automobile
insurance consumer information and complaint ranking; creates office of public
insurance consumer advocate and powers and duties therefor; makes related
provisions. |
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Enacts the New
York automobile insurance fraud and premium reduction act; provides that
this act is aimed at reducing insurance fraud and thus
lowering the cost of
insurance premiums; provides a provision for compensation to
a person that
reports insurance fraud to the authorities; further provides
that this act also
increases the penalty for insurance fraud; appropriates $3,100,000
therefor. |
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Directs the
superintendent of insurance to promulgate rules and
regulations limiting the use
of credit scores to determine automobile insurance premiums |
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Reduces the cost
of auto insurance for any automobile equipped with side door
airbags |
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Clarifies remedy
for overdue first party claim under no-fault automobile insurance and
increases penalties for insurance fraud. |
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Reduces a
retired or disabled owner's no fault insurance premium by
providing appropriate
automobile insurance rates to reflect a reduced exposure to
loss due to
situations where drivers either have no wages to lose or are covered
for lost wages by
another first payer insurance policy; defines "retired"
and "disabled". |
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Establishes an
insurer may not exclude basic economic loss from certain coverages;
establishes where a covered person is guilty of operating a
motor vehicle under
the influence of alcohol or drugs that an insurer has a cause
of action for the
amount of first party benefits paid or payable on behalf of
such covered person
against such covered person. |
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Provides that
with respect to a serious personal injury action still permissible
under the no-fault insurance system, the award or decision of
an arbitrator or
master arbitrator rendered in a no-fault arbitration will
not constitute a
collateral estoppel of the issues arbitrated. |
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Establishes
certain terms to be included in no-fault automobile
liability insurance
policies; provides that any covered person under such a policy
shall have 6 months to
provide the insurer of his or her claim for compensation; authorizes
service of notice of claim upon the state insurance fund when
the appropriate
insurer liable for a claim cannot be ascertained;
authorizes extensions of
the 6 month filing requirement if the claimant has a
reasonable justification
based on the preponderance of the evidence. |
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Relates to
requiring all no-fault insurance claims to be submitted to arbitration. |
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Relates to
unauthorized providers of health services. |
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Establishes an
insurer may not exclude basic economic loss from certain coverages;
establishes where a covered person is guilty of operating a
motor vehicle under
the influence of alcohol or drugs that an insurer has a cause
of action for the
amount of first party benefits paid or payable on behalf of
such covered person
against such covered person. |
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A10738 and S7531 |
Requires all
motor vehicle insurers to file annual detailed financial and
claim data
statements with the superintendent of insurance; all such statements
shall be made
available to the public. |
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A10739 |
Adds to the definition of serious injury and relates to determining the sufficiency of the evidence related to the serious injury; question of fact determined by the trier. |
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