S T A T E O F N E W Y O R K
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5146
2013-2014 Regular Sessions
I N A S S E M B L Y
February 20, 2013
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Introduced by M. of A. GOTTFRIED, PAULIN -- Multi-Sponsored by -- M. of
A. KELLNER, MILLMAN, WEISENBERG -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to assignment of rights
by the insured
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 30 to read as follows:
(30) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY OR
WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY NECESSARY
HEALTH CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S OBLIGATION OR
REQUIREMENTS UNDER SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
S 2. Section 3221 of the insurance law is amended by adding a new
subsection (s) to read as follows:
(S) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN POLICY OR
WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS CONTRACT
WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN AN INSURED
ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY NECESSARY
HEALTH CARE SERVICES TO A HEALTH CARE PROVIDER, THE INSURER SHALL REMIT
PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE HEALTH CARE PROVIDER. WHEN
AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT SENT TO THE INSURED RATHER THAN
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01207-01-3
A. 5146 2
TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY THE PLAN'S OBLIGATION OR
REQUIREMENTS UNDER SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
THIS ARTICLE AND IS SUBJECT TO INTEREST CHARGE PURSUANT TO SECTION THREE
THOUSAND TWO HUNDRED TWENTY-FOUR-A OF THIS ARTICLE.
S 3. Section 4303 of the insurance law is amended by adding a new
subsection (a-1) to read as follows:
(A-1) EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION
OR HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR
SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PERMIT BY CONTRACT, WRITTEN
POLICY OR WRITTEN PROCEDURE AN INSURED TO ASSIGN HIS RIGHTS UNDER HIS
CONTRACT WITH THE INSURER TO AN OUT-OF-PLAN HEALTH CARE PROVIDER. WHEN
AN INSURED ASSIGNS HIS RIGHT TO RECEIVE REIMBURSEMENT FOR MEDICALLY
NECESSARY HEALTH CARE SERVICES TO AN OUT-OF-PLAN HEALTH CARE PROVIDER,
THE INSURER SHALL REMIT PAYMENT FOR THE REIMBURSEMENT DIRECTLY TO THE
HEALTH CARE PROVIDER. WHEN AN ASSIGNMENT HAS BEEN MADE, ANY PAYMENT MADE
TO THE INSURED RATHER THAN TO THE HEALTH CARE PROVIDER SHALL NOT SATISFY
THE PLAN'S OBLIGATION OR REQUIREMENTS UNDER SECTION THREE THOUSAND TWO
HUNDRED TWENTY-FOUR-A OF THIS CHAPTER AND IS SUBJECT TO AN INTEREST
CHARGE PURSUANT TO SECTION THREE THOUSAND TWO HUNDRED TWENTY-FOUR-A OF
THIS CHAPTER.
S 4. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law, and shall apply to all
policies and contracts issued, renewed, modified, altered or amended on
or after such effective date.