Section 3224. Standard claim forms; accident and health insurance  


Latest version.
  • (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.