Bill Text: NY A10784 | 2011-2012 | General Assembly | Introduced
Bill Title: Relates to limits on certain supplementary insurance; permits insured to refuse supplementary insurance; requires certain disclaimer; relates to payments to durable medical equipment providers.
Spectrum: Slight Partisan Bill (Democrat 12-4)
Status: (Vetoed) 2012-12-17 - tabled [A10784 Detail]
Download: New_York-2011-A10784-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 10784 I N A S S E M B L Y June 18, 2012 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Morelle) -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to limits on certain supplementary insurance; and in relation to payments to durable medical equipment providers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Paragraph 2 of subsection (f) of section 3420 of the insur- 2 ance law, as separately amended by chapters 547 and 568 of the laws of 3 1997, is amended to read as follows: 4 (2) (A) Any such policy shall[, at the option of the insured, also] 5 provide supplementary uninsured/underinsured motorists insurance for 6 bodily injury[, in an amount up to] IN THE SAME AMOUNT AS the bodily 7 injury liability insurance limits of coverage provided under such AUTO- 8 MOBILE INSURANCE policy[, subject to a maximum of two hundred fifty 9 thousand dollars because of bodily injury to or death of one person in 10 any one accident and, subject to such limit for one person, up to five 11 hundred thousand dollars because of bodily injury to or death of two or 12 more persons in any one accident, or a combined single limit policy of 13 five hundred thousand dollars because of bodily injury to or death of 14 one or more persons in any one accident. Provided however, an insurer 15 issuing such policy, in lieu of offering to the insured the coverages 16 stated above, may provide supplementary uninsured/underinsured motorists 17 insurance for bodily injury, in an amount up to the bodily injury 18 liability insurance limits of coverage provided under such policy, 19 subject to a maximum of one hundred thousand dollars because of bodily 20 injury to or death of one person in any one accident and, subject to 21 such limit for one person, up to three hundred thousand dollars because 22 of bodily injury to or death of two or more persons in any one accident, 23 or a combined single limit policy of three hundred thousand dollars 24 because of bodily injury to or death of one or more persons in any one 25 accident, if such insurer also makes available a personal umbrella poli- 26 cy with liability coverage limits up to at least five hundred thousand 27 dollars which also provides coverage for supplementary EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD15532-07-2 A. 10784 2 1 uninsured/underinsured motorists claims]. THE COVERAGE REQUIRED UNDER 2 THIS PARAGRAPH IS NOT APPLICABLE WHEN, OR TO THE EXTENT THAT, AN INSURED 3 NAMED IN THE POLICY MAKES A REJECTION OF THE COVERAGE ON BEHALF OF ALL 4 INSUREDS UNDER THE POLICY. SUCH REJECTION SHALL BE MEMORIALIZED BY THE 5 INSURER THROUGH A SIGNED WRITING, AUDIO RECORDING, ELECTRONIC SIGNATURE 6 OR ANY OTHER MEANS EVIDENCING THE INSURED'S REJECTION OF SUCH COVERAGE. 7 Supplementary uninsured/underinsured motorists insurance shall provide 8 coverage, in any state or Canadian province, if the limits of liability 9 under all bodily injury liability bonds and insurance policies of 10 [another] ANY OTHER motor vehicle liable for damages are in a lesser 11 amount than the bodily injury liability insurance limits of coverage 12 provided by such policy. Upon written request by any insured covered by 13 supplemental uninsured/underinsured motorists insurance or his duly 14 authorized representative and upon disclosure by the insured of the 15 insured's bodily injury and supplemental uninsured/underinsured motor- 16 ists insurance coverage limits, the insurer of any other owner or opera- 17 tor of another motor vehicle against which a claim has been made for 18 damages to the insured shall disclose, within forty-five days of the 19 request, the bodily injury liability insurance limits of its coverage 20 provided under the policy or all bodily injury liability bonds. The time 21 of the insured to make any supplementary uninsured/underinsured motorist 22 claim, shall be tolled during the period the insurer of any other owner 23 or operator of another motor vehicle that may be liable for damages to 24 the insured, fails to so disclose its coverage. As a condition precedent 25 to the obligation of the insurer to pay under the supplementary 26 uninsured/underinsured motorists insurance coverage, the limits of 27 liability of all bodily injury liability bonds or insurance policies 28 applicable at the time of the accident shall be exhausted by payment of 29 judgments or settlements. 30 (B) [In addition to the notice provided, upon issuance of a policy of 31 motor vehicle liability insurance pursuant to regulations promulgated by 32 the superintendent, insurers shall notify insureds, in writing, of the 33 availability of supplementary uninsured/underinsured motorists coverage. 34 Such notification shall contain an explanation of supplementary 35 uninsured/underinsured motorists coverage and the amounts in which it 36 can be purchased. Subsequently, a notification of availability shall be 37 provided at least once a year and may be simplified pursuant to regu- 38 lations promulgated by the superintendent, but must include a concise 39 statement that supplementary uninsured/underinsured motorists coverage 40 is available, an explanation of such coverage, and the coverage limits 41 that can be purchased from the insurer.] IF THE REJECTION OR SELECTION 42 OF LOWER SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS COVERAGE IS IN 43 WRITTEN OR ELECTRONIC FORM, THAT REJECTION OR SELECTION SHALL BE MADE ON 44 A FORM PROVIDED TO THE INSURED AT THE TIME THE POLICY IS SOLD, PURCHASED 45 AND/OR NEGOTIATED THAT SHALL FULLY ADVISE THE INSURED OF THE NATURE OF 46 THE COVERAGE AND SHALL STATE THAT THE COVERAGE IS EQUAL TO BODILY INJURY 47 LIABILITY LIMITS UNLESS LOWER LIMITS ARE REQUESTED OR THE COVERAGE IS 48 REJECTED. WHERE SUCH SELECTION OR REJECTION IS MADE VERBALLY, A MEMORI- 49 ALIZATION IN WRITING OR ELECTRONIC SIGNATURE MAY BE RECEIVED BY THE 50 INSURER SUBSEQUENT TO THE SALE, PURCHASE AND/OR NEGOTIATION OF THE POLI- 51 CY. THE FORM SHALL BE IN 12-POINT BOLD TYPE AND SHALL STATE: "SUPPLE- 52 MENTARY UNINSURED/UNDERINSURED MOTORISTS COVERAGE (SUM COVERAGE) 53 PROTECTS AGAINST THE POSSIBILITY OF AN ACCIDENT INVOLVING ANOTHER MOTOR 54 VEHICLE WHOSE OWNER OR OPERATOR WAS NEGLIGENT AND WHO MAY HAVE NO INSUR- 55 ANCE WHATSOEVER; OR EVEN IF INSURED, IS ONLY INSURED FOR THIRD-PARTY 56 BODILY INJURY AT RELATIVELY LOW LIABILITY LIMITS, IN COMPARISON TO THE A. 10784 3 1 POLICYHOLDER'S OWN LIABILITY LIMITS FOR BODILY INJURY SUSTAINED BY 2 THIRD-PARTIES. BY PURCHASING SUM COVERAGE, THE POLICYHOLDER AND ANY 3 INSURED UNDER THE POLICY CAN BE PROTECTED FOR BODILY INJURY TO THEM- 4 SELVES AND RECEIVE FROM THE POLICYHOLDER'S OWN INSURER PAYMENT FOR BODI- 5 LY INJURY SUSTAINED DUE TO THE NEGLIGENCE OF THE OTHER MOTOR VEHICLE'S 6 OWNER OR OPERATOR. SUM COVERAGE SHALL BE EQUAL TO BODILY INJURY LIABIL- 7 ITY LIMITS UNLESS LOWER LIMITS ARE REQUESTED OR THE COVERAGE IS 8 REJECTED. A POLICYHOLDER IS URGED TO CONSIDER PURCHASING THE MAXIMUM SUM 9 COVERAGE AVAILABLE." IF REJECTION OR SELECTION OF LOWER LIMITS IS MADE 10 VERBALLY, THE INSURER OR THEIR AGENT SHALL READ THE IDENTICAL OR 11 SUBSTANTIALLY SIMILAR LANGUAGE AS IS IN THE ABOVE REJECTION OF MATCHING 12 LIMITS FORM AND CONFIRM THE CLIENT HAS HEARD AND UNDERSTOOD THE SAME, 13 AND SHALL RESTATE THE ABOVE INFORMATION AS OFTEN AS IS NECESSARY UNTIL 14 THE INSURED HAS VERBALLY CONFIRMED THAT THEY FULLY UNDERSTAND THE SAME. 15 THE INSURER SHALL NOTIFY THE NAMED INSURED AT LEAST ANNUALLY OF HER OR 16 HIS OPTIONS AS TO THE COVERAGE REQUIRED BY THIS PARAGRAPH PURSUANT TO 17 REGULATIONS ISSUED BY THE SUPERINTENDENT, IF ANY, AT THE TIME OF OR 18 WITHIN SIXTY DAYS PRIOR TO THE RENEWAL OF THE POLICY. RECEIPT OF THIS 19 NOTICE DOES NOT CONSTITUTE AN AFFIRMATIVE WAIVER OF THE INSURED'S RIGHT 20 TO UNINSURED MOTORIST COVERAGE WHERE THE INSURED HAS NOT SIGNED A 21 SELECTION OR REJECTION FORM. 22 S 2. The insurance law is amended by adding a new section 5109-a to 23 read as follows: 24 S 5109-A. UNAUTHORIZED PROVIDERS OF DURABLE MEDICAL EQUIPMENT. (A) THE 25 SUPERINTENDENT MAY PROHIBIT A PROVIDER OF DURABLE MEDICAL EQUIPMENT FROM 26 DEMANDING OR REQUESTING PAYMENT UNDER THIS ARTICLE FOR DURABLE MEDICAL 27 EQUIPMENT FOR A PERIOD TO BE DETERMINED BY THE SUPERINTENDENT IF THE 28 SUPERINTENDENT DETERMINES, AFTER NOTICE AND A HEARING, THAT THE PROVIDER 29 OF DURABLE MEDICAL EQUIPMENT: 30 (1) HAS ENGAGED IN A PATTERN AND PRACTICE OF FRAUDULENT, EXCESSIVE OR 31 UNLAWFUL BILLING OF INSURANCE COMPANIES FOR DURABLE MEDICAL EQUIPMENT; 32 (2) HAS ENGAGED IN A PATTERN AND PRACTICE OF BILLING INSURANCE COMPA- 33 NIES FOR DURABLE MEDICAL EQUIPMENT WHICH WAS NOT PROVIDED; 34 (3) HAS ENGAGED IN A PATTERN AND PRACTICE OF BILLING INSURANCE COMPA- 35 NIES FOR DURABLE MEDICAL EQUIPMENT WHICH WAS NOT NECESSARY; 36 (4) HAS COMMITTED A FRAUDULENT INSURANCE ACT AS DEFINED IN SECTION 37 176.05 OF THE PENAL LAW; 38 (5) HAS BEEN CONVICTED OF A CRIME INVOLVING FRAUDULENT OR DISHONEST 39 PRACTICES; 40 (6) HAS REFUSED TO APPEAR BEFORE, OR ANSWER ANY QUESTION UPON REQUEST 41 OF, THE SUPERINTENDENT OR ANY DULY AUTHORIZED OFFICER OF THIS STATE OR 42 REFUSED TO PRODUCE ANY RELEVANT INFORMATION CONCERNING THE CONDUCT OF 43 THE PROVIDER OF DURABLE MEDICAL EQUIPMENT IN CONNECTION WITH DURABLE 44 MEDICAL EQUIPMENT PROVIDED UNDER THIS ARTICLE; OR 45 (7) HAS VIOLATED ANY PROVISION OF THIS ARTICLE OR REGULATIONS PROMUL- 46 GATED THEREUNDER. 47 (B) A PROVIDER OF DURABLE MEDICAL EQUIPMENT SHALL NOT DEMAND OR 48 REQUEST PAYMENT UNDER THIS ARTICLE FOR DURABLE MEDICAL EQUIPMENT DURING 49 THE TERM OF THE PROHIBITION ORDERED BY THE SUPERINTENDENT PURSUANT TO 50 SUBSECTION (A) OF THIS SECTION. 51 (C) THE SUPERINTENDENT SHALL MAINTAIN A DATABASE CONTAINING A LIST OF 52 PROVIDERS OF DURABLE MEDICAL EQUIPMENT PROHIBITED BY THIS SECTION FROM 53 DEMANDING OR REQUESTING PAYMENT FOR DURABLE MEDICAL EQUIPMENT RENDERED 54 UNDER THIS ARTICLE AND SHALL MAKE THE INFORMATION AVAILABLE TO THE 55 PUBLIC. A. 10784 4 1 (D) NOTHING IN THIS SECTION SHALL BE CONSTRUED AS LIMITING IN ANY 2 RESPECT THE POWERS AND DUTIES OF ANY OTHER STATE OR FEDERAL AGENCY OR 3 INSURERS TO INVESTIGATE INSTANCES OF MISCONDUCT BY DURABLE MEDICAL 4 EQUIPMENT PROVIDERS AND TAKE APPROPRIATE ACTION PURSUANT TO ANY OTHER 5 PROVISION OF LAW. 6 S 3. This act shall take effect on the one hundred eightieth day after 7 it shall have become a law, and shall apply to insurance policies and 8 contracts issued, entered into or renewed on and after such effective 9 date.