Assembly Bill A10534

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  10534

                          I N  A S S E M B L Y

                              June 4, 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  the  assignment  of
  claims for certain medical expenses

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  5110
to read as follows:
  S  5110.  ASSIGNMENT  OF  BENEFITS  FOR AUTHORIZED PROVIDERS OF HEALTH
SERVICES. (A) (1) A COVERED PERSON HAS THE RIGHT TO ASSIGN A  CLAIM  FOR
INCURRED MEDICAL EXPENSES UNDER THIS ARTICLE TO A HEALTH SERVICE PROVID-
ER,  AND SUCH ASSIGNMENT SHALL AFFORD THE HEALTH SERVICE PROVIDER AS THE
ASSIGNEE, THE RIGHTS, PRIVILEGES, AND REMEDIES FOR PAYMENT BASED ON  THE
INJURY  OR INJURIES ALLEGED BY THE COVERED PERSON IN A CLAIM THAT ARISES
OUT OF AND IS RELATED TO THE SAME ACCIDENT AND INVOLVES COMMON ISSUES OF
FACT.
  (2) SUCH ASSIGNMENT IS VALID ONLY:
  (I) WHERE COVERAGE AND COMPLIANCE WITH EITHER INSURANCE  POLICY  TERMS
BY  THE  COVERED  PERSON  OR  A SELF INSURED FINANCIAL OBLIGATION, WHICH
PROVIDES THE FINANCIAL SECURITY REQUIRED BY ARTICLE SIX OR EIGHT OF  THE
VEHICLE AND TRAFFIC LAW, ARE NOT IN DISPUTE, AND
  (II)  A  COVERED  PERSON HAS PROVIDED THE INSURER OR SELF INSURER WITH
ALL CONDITIONS PRECEDENT FOR A CLAIM,  CONSISTENT  WITH  THE  RULES  AND
REGULATIONS PRESCRIBED THEREFOR BY THE DEPARTMENT.
  (B) THE COVERED PERSON SHALL HAVE THE SOLE RIGHT TO CONTEST ANY ISSUES
INVOLVING  COVERAGE,  COMPLIANCE WITH POLICY TERMS, OR CONDITIONS PRECE-
DENT TO ANY SELF INSURED FINANCIAL OBLIGATION, FOR THE COVERED PERSON.
  (C) THE HEALTH SERVICE PROVIDER SHALL HAVE A LIEN AGAINST ANY RECOVERY
BY THE COVERED PERSON FOR SERVICES PROVIDED.
  (D) THE HEALTH SERVICE PROVIDER SHALL NOT PURSUE PAYMENT FOR THE  COST
OF SERVICES ARISING OUT OF THE INJURIES THE COVERED PERSON SUSTAINED DUE
TO  A MOTOR VEHICLE ACCIDENT UNLESS THERE IS A DETERMINATION THAT EITHER
INSURANCE COVERAGE DOES NOT EXIST OR WHERE THERE IS A DETERMINATION THAT
SUCH COVERED PERSON IS NOT ENTITLED TO BENEFITS OF A SELF INSURED FINAN-
CIAL OBLIGATION WHICH PROVIDES THE FINANCIAL SECURITY REQUIRED BY  ARTI-
CLE SIX OR EIGHT OF THE VEHICLE AND TRAFFIC LAW.
  S 2. This act shall take effect immediately.
              

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD16099-01-2