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This entry was published on 2014-09-22
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Coordination of benefits
Insurance (ISC) CHAPTER 28, ARTICLE 32
§ 3224-c. Coordination of benefits. An insurer or organization or
corporation licensed or certified pursuant to article forty-three or
forty-seven of this chapter or article forty-four of the public health
law shall not deny a claim, either in whole or in part, on the basis
that it is coordinating benefits and another insurer or organization or
corporation or other entity is liable for the payment of the claim,
unless it has a reasonable basis to believe that the insured has other
health insurance coverage which is primary for that benefit. If an
insurer or organization or corporation does not have current information
from the insured regarding other coverage, and requests such information
in accordance with subsection (b) of section three thousand two hundred
twenty-four-a of this article, and no information is received within
forty-five days, the claim shall be adjudicated provided, however, the
claim shall not be denied based on the insurer, or organization or
corporation not having received such information.