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This entry was published on 2014-09-22
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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.