•  Summary 
  •  Actions 
  •  Committee Votes 
  •  Floor Votes 
  •  Memo 
  •  Text 
  •  LFIN 
  •  Chamber Video/Transcript 

S00344 Summary:

Add §5110, Ins L
Requires that insurers providing no-fault coverage reimburse other insurers for the payment of claims to providers which should have been covered by a no-fault insurer.
Go to top

S00344 Text:

                STATE OF NEW YORK
                               2023-2024 Regular Sessions
                    IN SENATE
                                     January 4, 2023
        Introduced by Sen. GOUNARDES -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
        AN  ACT  to  amend the insurance law, in relation to the coordination of
          no-fault benefits for persons injured in motor vehicle accidents

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  The insurance law is amended by adding a new section 5110
     2  to read as follows:
     3    § 5110. Payment for services provided for motor vehicle  injuries.  1.
     4  Any  provider  of  treatment  to any covered person, who renders care or
     5  supplies a product within seventy-two hours of the motor  vehicle  acci-
     6  dent,  in  the absence of fraud or deception by the claimant, is conclu-
     7  sively presumed to have accepted, and to have consented to,  an  assign-
     8  ment  of  no-fault benefits under this article in the form prescribed by
     9  the superintendent.  The provisions of this subdivision shall  apply  if
    10  the  provider  knows,  or  is  on notice of facts that indicate that the
    11  injuries or conditions treated are the result of a motor  vehicle  acci-
    12  dent which occurred in the preceding seventy-two hours.
    13    2.  Any  provider  of  treatment to a covered person who mistakenly or
    14  otherwise bills an insurer other than the no-fault  insurer  for  claims
    15  eligible  for first-party benefits under this article must, upon presen-
    16  tation with proof of applicable coverage under  article  six,  eight  or
    17  forty-four-B  of  the vehicle and traffic law, return such fees and seek
    18  payment for services from the no-fault insurer instead. A provider shall
    19  be permitted to maintain insurance information in the event it is estab-
    20  lished that there are no first-party benefits  available  for  emergency
    21  treatment under this article.
    22    3.  The time limit for presentation of invoices to an insurer shall be
    23  measured from the first date on which the provider or the patient  first
    24  presented the invoice to any insurer.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        S. 344                              2
     1    4.   Any   compensation   provider  that,  notwithstanding  the  other
     2  provisions of this law, pays for the emergency treatment  of  a  covered
     3  person,  has  a  right  of  direct action against the insurer liable for
     4  coverage under this article for reimbursement, but in no case  will  the
     5  reimbursement  exceed  the amount of lawful benefits according to state-
     6  promulgated fee schedules.
     7    5. No insurer providing coverage  under  this  article  shall  exclude
     8  reimbursement  for first-party benefits which have been paid to a health
     9  care provider or medical equipment supplier by a  compensation  provider
    10  not under this article.
    11    § 2. This act shall take effect immediately.
Go to top