Bill Text: NY S07779 | 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 certain claims of durable medical equipment providers.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2012-06-18 - REFERRED TO RULES [S07779 Detail]
Download: New_York-2011-S07779-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 7779 I N S E N A T E June 18, 2012 ___________ Introduced by Sen. SEWARD -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the insurance law, in relation to limits on certain supplementary insurance; and in relation to providers of durable medical equipment 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] PRIVATE PASSENGER AUTOMOBILE INSURANCE policy 5 shall[, at the option of the insured, also] provide supplementary 6 uninsured/underinsured motorists insurance for bodily injury[, in an 7 amount up to] IN THE SAME AMOUNT AS the bodily injury liability insur- 8 ance limits of coverage provided under [such] THE PRIVATE PASSENGER 9 AUTOMOBILE INSURANCE policy[, subject to a maximum of two hundred fifty 10 thousand dollars because of bodily injury to or death of one person in 11 any one accident and, subject to such limit for one person, up to five 12 hundred thousand dollars because of bodily injury to or death of two or 13 more persons in any one accident, or a combined single limit policy of 14 five hundred thousand dollars because of bodily injury to or death of 15 one or more persons in any one accident. Provided however, an insurer 16 issuing such policy, in lieu of offering to the insured the coverages 17 stated above, may provide supplementary uninsured/underinsured motorists 18 insurance for bodily injury, in an amount up to the bodily injury 19 liability insurance limits of coverage provided under such policy, 20 subject to a maximum of one hundred thousand dollars because of bodily 21 injury to or death of one person in any one accident and, subject to 22 such limit for one person, up to three hundred thousand dollars because 23 of bodily injury to or death of two or more persons in any one accident, 24 or a combined single limit policy of three hundred thousand dollars 25 because of bodily injury to or death of one or more persons in any one 26 accident, if such insurer also makes available a personal umbrella poli- 27 cy with liability coverage limits up to at least five hundred thousand EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD16335-01-2 S. 7779 2 1 dollars which also provides coverage for supplementary 2 uninsured/underinsured motorists claims]. THE COVERAGE REQUIRED UNDER 3 THIS PARAGRAPH IS NOT APPLICABLE WHEN, OR TO THE EXTENT THAT, AN INSURED 4 NAMED IN THE POLICY MAKES A REJECTION OF THE COVERAGE ON BEHALF OF ALL 5 INSUREDS UNDER THE POLICY. SUCH REJECTION MAY BE MEMORIALIZED BY THE 6 INSURER THROUGH A SIGNED WRITING, AUDIO RECORDING, ELECTRONIC SIGNATURE 7 OR ANY OTHER MEANS EVIDENCING THE INSURED'S REJECTION OF SUCH COVERAGE. 8 Supplementary uninsured/underinsured motorists insurance shall provide 9 coverage, in any state or Canadian province, if the limits of liability 10 under all bodily injury liability bonds and insurance policies of 11 [another] ANY OTHER motor vehicle liable for damages are in a lesser 12 amount than the bodily injury liability insurance limits of coverage 13 provided by such policy. Upon written request by any insured covered by 14 supplemental uninsured/underinsured motorists insurance or his duly 15 authorized representative and upon disclosure by the insured of the 16 insured's bodily injury and supplemental uninsured/underinsured motor- 17 ists insurance coverage limits, the insurer of any other owner or opera- 18 tor of another motor vehicle against which a claim has been made for 19 damages to the insured shall disclose, within forty-five days of the 20 request, the bodily injury liability insurance limits of its coverage 21 provided under the policy or all bodily injury liability bonds. The time 22 of the insured to make any supplementary uninsured/underinsured motorist 23 claim, shall be tolled during the period the insurer of any other owner 24 or operator of another motor vehicle that may be liable for damages to 25 the insured, fails to so disclose its coverage. As a condition precedent 26 to the obligation of the insurer to pay under the supplementary 27 uninsured/underinsured motorists insurance coverage, the limits of 28 liability of [all] bodily injury liability bonds or insurance policies 29 applicable at the time of the accident shall be exhausted by payment of 30 judgments or settlements. 31 (B) [In addition to the notice provided, upon issuance of a policy of 32 motor vehicle liability insurance pursuant to regulations promulgated by 33 the superintendent,] AT THE TIME THE POLICY IS SOLD, PURCHASED OR NEGO- 34 TIATED insurers shall notify insureds, in [writing] WRITTEN, VERBAL OR 35 ELECTRONIC FORMAT, of the NATURE AND availability of supplementary 36 uninsured/underinsured motorists coverage AND SHALL STATE THAT THE 37 COVERAGE IS EQUAL TO BODILY INJURY LIABILITY LIMITS UNLESS LOWER LIMITS 38 ARE REQUESTED OR THE COVERAGE IS REJECTED. Such notification shall 39 contain an explanation of supplementary uninsured/underinsured motorists 40 coverage and the amounts in which it can be purchased. SUCH NOTICE 41 SHALL STATE THE FOLLOWING OR INCLUDE INFORMATION SUBSTANTIALLY SIMILAR 42 TO THE FOLLOWING: 43 "SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS COVERAGE (SUM COVER- 44 AGE) SHALL BE EQUAL TO BODILY INJURY LIABILITY LIMITS UNLESS LOWER 45 LIMITS ARE REQUESTED OR THE COVERAGE IS REJECTED. A POLICYHOLDER SHOULD 46 CONSIDER PURCHASING SUM COVERAGE IN ORDER TO PROTECT AGAINST THE POSSI- 47 BILITY OF AN ACCIDENT INVOLVING ANOTHER MOTOR VEHICLE WHOSE OWNER OR 48 OPERATOR WAS NEGLIGENT AND WHO MAY HAVE NO INSURANCE WHATSOEVER; OR EVEN 49 IF INSURED, IS ONLY INSURED FOR THIRD-PARTY BODILY INJURY AT RELATIVELY 50 LOW LIABILITY LIMITS, IN COMPARISON TO THE POLICYHOLDER'S OWN LIABILITY 51 LIMITS FOR BODILY INJURY SUSTAINED BY THIRD-PARTIES. BY PURCHASING SUM 52 COVERAGE, WHICH CANNOT BE PURCHASED IN AN AMOUNT EXCEEDING THE AMOUNT OF 53 THIRD PARTY LIABILITY COVERAGE PURCHASED, THE POLICYHOLDER AND ANY 54 INSURED UNDER THE POLICY CAN BE PROTECTED FOR BODILY INJURY TO THEM- 55 SELVES, UP TO THE LIMIT OF THE SUM COVERAGE PURCHASED; AND RECEIVE FROM 56 THE POLICYHOLDER'S OWN INSURANCE PAYMENT FOR BODILY INJURY SUSTAINED DUE S. 7779 3 1 TO THE NEGLIGENCE OF THE OTHER MOTOR VEHICLE'S OWNER OR OPERATOR." 2 Subsequently, a notification of availability shall be provided at least 3 once a year and may be simplified pursuant to regulations promulgated by 4 the superintendent, but must include a concise statement that supplemen- 5 tary uninsured/underinsured motorists coverage is available, an explana- 6 tion of such coverage, and the coverage limits that can be purchased 7 from the insurer. 8 (C) WHEN THERE IS A DISPUTE BETWEEN AN INSURER AND INSURED OVER THE 9 AMOUNT OF SUPPLEMENTARY UNINSURED/UNDERINSURED MOTORISTS COVERAGE AVAIL- 10 ABLE ON A CLAIM AND THE INSURER ULTIMATELY PROVIDES COVERAGE HIGHER THAN 11 THE AMOUNT OF PREMIUM THE INSURER IS CHARGING FOR, AN INSURER MAY DEDUCT 12 ANY PREMIUM DUE FROM A RE-RATING OF THE POLICY BACK TO THE POLICY ISSUE 13 DATE AGAINST ANY BENEFITS DUE ON THE CLAIM. 14 S 2. The insurance law is amended by adding a new section 5109-a to 15 read as follows: 16 S 5109-A. UNAUTHORIZED PROVIDERS OF DURABLE MEDICAL EQUIPMENT. (A) THE 17 SUPERINTENDENT MAY PROHIBIT A PROVIDER OF DURABLE MEDICAL EQUIPMENT FROM 18 DEMANDING OR REQUESTING PAYMENT UNDER THIS ARTICLE FOR DURABLE MEDICAL 19 EQUIPMENT FOR A PERIOD TO BE DETERMINED BY THE SUPERINTENDENT IF THE 20 SUPERINTENDENT DETERMINES, AFTER NOTICE AND A HEARING, THAT THE PROVIDER 21 OF DURABLE MEDICAL EQUIPMENT: 22 (1) HAS ENGAGED IN FRAUDULENT, EXCESSIVE OR UNLAWFUL BILLING OF INSUR- 23 ANCE COMPANIES FOR DURABLE MEDICAL EQUIPMENT; 24 (2) HAS BILLED INSURANCE COMPANIES FOR DURABLE MEDICAL EQUIPMENT WHICH 25 WAS NOT PROVIDED; 26 (3) HAS BILLED INSURANCE COMPANIES FOR DURABLE MEDICAL EQUIPMENT WHICH 27 WAS NOT NECESSARY; 28 (4) HAS COMMITTED A FRAUDULENT INSURANCE ACT AS DEFINED IN SECTION 29 176.05 OF THE PENAL LAW; 30 (5) HAS BEEN CONVICTED OF A CRIME INVOLVING FRAUDULENT OR DISHONEST 31 PRACTICES; 32 (6) HAS REFUSED TO APPEAR BEFORE, OR ANSWER ANY QUESTION UPON REQUEST 33 OF, THE SUPERINTENDENT OR ANY DULY AUTHORIZED OFFICER OF THIS STATE OR 34 REFUSED TO PRODUCE ANY RELEVANT INFORMATION CONCERNING THE CONDUCT OF 35 THE PROVIDER OF DURABLE MEDICAL EQUIPMENT IN CONNECTION WITH DURABLE 36 MEDICAL EQUIPMENT PROVIDED UNDER THIS ARTICLE; OR 37 (7) HAS VIOLATED ANY PROVISION OF THIS ARTICLE OR REGULATIONS PROMUL- 38 GATED THEREUNDER. 39 (B) A PROVIDER OF DURABLE MEDICAL EQUIPMENT SHALL NOT DEMAND OR 40 REQUEST PAYMENT UNDER THIS ARTICLE FOR DURABLE MEDICAL EQUIPMENT DURING 41 THE TERM OF THE PROHIBITION ORDERED BY THE SUPERINTENDENT PURSUANT TO 42 SUBSECTION (A) OF THIS SECTION. 43 (C) THE SUPERINTENDENT SHALL MAINTAIN A DATABASE CONTAINING A LIST OF 44 PROVIDERS OF DURABLE MEDICAL EQUIPMENT PROHIBITED BY THIS SECTION FROM 45 DEMANDING OR REQUESTING PAYMENT FOR DURABLE MEDICAL EQUIPMENT RENDERED 46 UNDER THIS ARTICLE AND SHALL MAKE THE INFORMATION AVAILABLE TO THE 47 PUBLIC. 48 (D) NOTHING IN THIS SECTION SHALL BE CONSTRUED AS LIMITING IN ANY 49 RESPECT THE POWERS AND DUTIES OF ANY OTHER STATE OR FEDERAL AGENCY OR 50 INSURERS TO INVESTIGATE INSTANCES OF MISCONDUCT BY DURABLE MEDICAL 51 EQUIPMENT PROVIDERS AND TAKE APPROPRIATE ACTION PURSUANT TO ANY OTHER 52 PROVISION OF LAW. 53 S 3. This act shall take effect on the one hundred eightieth day 54 after it shall have become a law, and shall apply to insurance policies 55 and contracts issued, entered into or renewed on and after such date.