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A10784 Summary:

A10784 Actions:

A10784 Floor Votes:

A10784 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          10784
 
                   IN ASSEMBLY
 
                                      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    § 2. The insurance law is amended by adding a new  section  5109-a  to
    23  read as follows:
    24    § 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    § 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.