Bill Text: MI HB5604 | 2015-2016 | 98th Legislature | Introduced

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Bill Title: Insurance; no-fault; processing of claims for benefits under the assigned claims plan; enact procedures. Amends sec. 3173a of 1956 PA 218 (MCL 500.3173a).

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2016-04-28 - Bill Electronically Reproduced 04/27/2016 [HB5604 Detail]

Download: Michigan-2015-HB5604-Introduced.html

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HOUSE BILL No. 5604

April 27, 2016, Introduced by Rep. Theis and referred to the Committee on Insurance.

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending section 3173a (MCL 500.3173a), as amended by 2012 PA

 

204.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3173a. (1) The Michigan automobile insurance placement

 

facility shall make an initial determination of a claimant's the

 

eligibility for benefits under the assigned claims plan for a

 

claimant or a person making a claim through or on behalf of a

 

claimant and shall deny an obviously ineligible a claim . The that

 

is determined to be ineligible under this chapter or the assigned

 

claims plan. A claimant or person making a claim through or on

 

behalf of a claimant that fails to cooperate is ineligible for

 

benefits under the assigned claims plan. The Michigan automobile

 

insurance placement facility shall notify the claimant shall be

notified promptly in writing of the a denial and the reasons for

 

the denial.

 

     (2) A claimant or a person making a claim through or on behalf

 

of a claimant shall cooperate in the investigation of eligibility

 

and the settlement or defense of any claim or suit, including, but

 

not limited to, submitting to examinations under oath and to

 

sections 3151 to 3153.

 

     (3) A person who has reason to believe that the Michigan

 

automobile insurance placement facility has improperly determined

 

that an application for benefits is ineligible is entitled to a

 

private, informal, managerial-level conference with the Michigan

 

automobile insurance placement facility.

 

     (4) The Michigan automobile insurance placement facility shall

 

establish reasonable internal procedures to provide a person with a

 

private, informal, managerial-level conference described in

 

subsection (3). The procedures must include all of the following:

 

     (a) A method of providing the person, on written request and

 

payment of a reasonable copying charge, with information pertinent

 

to the decision.

 

     (b) A method for resolving the dispute promptly and

 

informally, while protecting the interests of both the person and

 

the Michigan automobile insurance placement facility.

 

     (5) If the Michigan automobile insurance placement facility

 

fails to provide a conference under subsection (3) and a proposed

 

resolution of the dispute within 30 days after a request by a

 

person, or if the person disagrees with the proposed resolution of

 

the Michigan automobile insurance placement facility after

 

completion of the conference, the person is entitled to a

 

determination of the matter by the director. The director shall by

 

rule establish a procedure for determinations under this

 

subsection, which must be reasonably calculated to resolve these

 

matters informally and promptly, while protecting the interests of

 

both the person and the Michigan automobile insurance placement

 

facility.

 

     (6) The Michigan automobile insurance placement facility shall

 

close the claim file of a person who fails to appear for a

 

conference under subsection (3) or for a scheduled review by the

 

director.

 

     (7) (2) A person who presents or causes to be presented an

 

oral or written statement, including computer-generated

 

information, as part of or in support of a claim to the Michigan

 

automobile insurance placement facility, or to an insurer to which

 

the claim is assigned under the assigned claims plan, for payment

 

or another benefit knowing that the statement contains false

 

information concerning a fact or thing material to the claim

 

commits a fraudulent insurance act under section 4503 that is

 

subject to the penalties imposed under section 4511. A claim that

 

contains or is supported by a fraudulent insurance act as described

 

in this subsection is ineligible for payment or of personal

 

protection insurance benefits under the assigned claims plan.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.