2019 -- H 5462

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LC001197

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Representatives Jacquard, Ucci, Millea, Lima, and McNamara

     Date Introduced: February 14, 2019

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

Insurance Policies" is hereby amended by adding thereto the following section:

     27-18-61.1. Health insurance contracts -- Obligation to pay accident-negligence

claims.

     (a) Any health insurance contract, plan or policy delivered or issued for delivery in this

state shall provide coverage for any medical treatment received by any policy holder as a result of

being injured in a motor vehicle or other accident regardless of liability and regardless of whether

the policy holder is seeking or will seek damages from the responsible party.

     (b) No health insurance provider may deny payments for any health care or medical

treatment because its policy holder is seeking or may seek damages from the responsible party.

     (c) Upon payment by any health insurance provider under any contract, plan or policy

delivered or issued for delivery in this state, said provider shall notify the policy holder’s attorney

or the policy holder directly in the event that the policy holder is not represented by counsel, that

it has paid for medical services and that it shall have a lien on any recovery the policy holder

receives from any third party, entity or any insurer. Any such notice of lien shall entitle any

health care provider to subrogation of any payment it made on behalf of its policy holder from the

funds received from any third party, entity or any insurer.

     (d) Notwithstanding § 27-18-19 or any other provision to the contrary, this section shall

apply to blanket or group polices of insurance.

     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-52.1. Health insurance contracts -- Obligation to pay accident-negligence

claims.

     (a) Any health insurance contract, plan or policy delivered or issued for delivery in this

state shall provide coverage for any medical treatment received by any policy holder as a result of

being injured in a motor vehicle or other accident regardless of liability and regardless of whether

the policy holder is seeking or will seek damages from the responsible party.

     (b) No health insurance provider may deny payments for any health care or medical

treatment because its policy holder is seeking or may seek damages from the responsible party.

     (c) Upon payment by any health insurance provider under any contract, plan or policy

delivered or issued for delivery in this state, said provider shall notify the policy holder’s attorney

or the policy holder directly in the event that the policy holder is not represented by counsel, that

it has paid for medical services and that it shall have a lien on any recovery the policy holder

receives from any third party, entity or any insurer. Any such notice of lien shall entitle any

health care provider to subrogation of any payment it made on behalf of its policy holder from the

funds received from any third party, entity or any insurer.

     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-47.1. Health insurance contracts -- Obligation to pay accident-negligence

claims.

     (a) Any health insurance contract, plan or policy delivered or issued for delivery in this

state shall provide coverage for any medical treatment received by any policy holder as a result of

being injured in a motor vehicle or other accident regardless of liability and regardless of whether

the policy holder is seeking or will seek damages from the responsible party.

     (b) No health insurance provider may deny payments for any health care or medical

treatment because its policy holder is seeking or may seek damages from the responsible party.

     (c) Upon payment by any health insurance provider under any contract, plan or policy

delivered or issued for delivery in this state, said provider shall notify the policy holder’s attorney

or the policy holder directly in the event that the policy holder is not represented by counsel, that

it has paid for medical services and that it shall have a lien on any recovery the policy holder

receives from any third party, entity or any insurer. Any such notice of lien shall entitle any

health care provider to subrogation of any payment it made on behalf of its policy holder from the

funds received from any third party, entity or any insurer.

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     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-64.1. Health insurance contracts -- Obligation to pay accident-negligence

claims.

     (a) Any health insurance contract, plan or policy delivered or issued for delivery in this

state shall provide coverage for any medical treatment received by any policy holder as a result of

being injured in a motor vehicle or other accident regardless of liability and regardless of whether

the policy holder is seeking or will seek damages from the responsible party.

     (b) No health insurance provider may deny payments for any health care or medical

treatment because its policy holder is seeking or may seek damages from the responsible party.

     (c) Upon payment by any health insurance provider under any contract, plan or policy

delivered or issued for delivery in this state, said provider shall notify the policy holder’s attorney

or the policy holder directly in the event that the policy holder is not represented by counsel, that

it has paid for medical services and that it shall have a lien on any recovery the policy holder

receives from any third party, entity or any insurer. Any such notice of lien shall entitle any

health care provider to subrogation of any payment it made on behalf of its policy holder from the

funds received from any third party, entity or any insurer.

     SECTION 5. This act shall take effect upon passage.

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LC001197

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would require all health insurance providers to provide coverage for medical

services received by any policy holder for injuries received in a motor vehicle or other accident

regardless of whether the policy holder is seeking or may seek damages from a third party. This

would apply to nonprofit hospital service corporations, nonprofit medical service corporations

and health maintenance organizations.

     This act would take effect upon passage.

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LC001197

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