US Lawyer Database

For Lawyer-Seekers

YOU DESERVE THE BEST LAWYER

§  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.