Insurance Law 3224 — Legislation

Legislation Search OpenLegislation Statutes Search Term Search icon Search previous SECTION 3223 Group annuity contracts; standard provisions as to contractual rights and responsibilities of contract holders, certificate holders and a... up ARTICLE 32 Insurance Contracts - Life, Accident and Health, Annuities next SECTION 3224-A Standards for prompt, fair and equitable settlement of claims for health care and payments for health care services Viewing most recent revision (from 2014-09-22) View historical revision as of: -- Choose a Date -- 2014-09-22 Share Facebook Email SECTION 3224 Standard claim forms; accident and health insurance Insurance (ISC) CHAPTER 28, ARTICLE 32 § 3224. Standard claim forms; accident and health insurance. (a) The superintendent shall establish standard claim forms for the services of hospitals, physicians and other health care providers to be used for all accident and health insurance claims. All insurers providing such insurance shall accept said standard claim forms when submitted by a hospital, physician or other health care provider covering services rendered to an individual covered by the policy or when submitted by an insured covering these same services. Corporations operating under article forty-three of this chapter shall be required to use standard claim forms as established by the superintendent pursuant to this section. (b) The adoption of any uniform claim forms by the superintendent pursuant hereto shall not preclude an insurer from obtaining any necessary additional information regarding a claim from the claimant, provider of health care or treatment, or certifier of coverage. (c) The superintendent is authorized and empowered to take such action as he deems appropriate for the proper implementation hereof and to provide by rule and regulation that any form which does not comply with the provisions of this section shall not be issued or reissued. The rules and regulations so adopted shall specify an effective date, which shall not be less than one hundred eighty days after the date of adoption or promulgation, after which no insurer may require any hospital, physician, other health care provider or insured to complete forms differing from those prescribed by the superintendent pursuant hereto, other than additional requests for information pursuant to subsection (b) hereof.