Bill Text: MI HB4625 | 2017-2018 | 99th Legislature | Introduced

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Bill Title: Insurance; no-fault; processing of claims for benefits under the assigned claims plan; enact procedures. Amends sec. 3173a of 1956 PA 218 (MCL 500.3173a). TIE BAR WITH: HB 4624'17

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2017-05-25 - Referred To Second Reading [HB4625 Detail]

Download: Michigan-2017-HB4625-Introduced.html

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HOUSE BILL No. 4625

 

 

May 17, 2017, Introduced by Rep. Whiteford and referred to the Committee on Insurance.

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending section 3173a (MCL 500.3173a), as amended by 2012 PA

 

204.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3173a. (1) The Michigan automobile insurance placement

 

facility shall review a claim for personal protection insurance

 

benefits under the assigned claims plan, shall make an initial

 

determination of a claimant's the eligibility for benefits under

 

this chapter and the assigned claims plan, and shall deny an

 

obviously ineligible a claim . The that the Michigan automobile

 

insurance placement facility determines is ineligible under this

 

chapter or the assigned claims plan. If a claimant or person making

 

a claim through or on behalf of a claimant fails to cooperate with

 

the Michigan automobile insurance placement facility as required by

 

subsection (2), the claimant or person is ineligible for benefits

 

under the assigned claims plan. The Michigan automobile insurance

 

placement facility shall promptly notify in writing the claimant

 

shall be notified promptly in writing and any person that submitted

 

a claim through or on behalf of a claimant of the a denial and the

 

reasons for the denial.

 

     (2) A claimant or a person making a claim through or on behalf

 

of a claimant shall cooperate with the Michigan automobile

 

insurance placement facility in its determination of eligibility

 

and the settlement or defense of any claim or suit, including, but

 

not limited to, submitting to an examination under oath and

 

compliance with sections 3151 to 3153. There is a rebuttable

 

presumption that a person has satisfied the duty to cooperate under

 

this section if all of the following apply:

 

     (a) The person submitted a claim for personal protection

 

insurance benefits under the assigned claims plan by submitting to

 

the Michigan automobile insurance placement facility a complete

 

application on a form provided by the Michigan automobile insurance

 

placement facility in accordance with the assigned claims plan.

 

     (b) The person provided satisfactory proof of loss under the

 

assigned claims plan as described in section 3172.

 

     (c) If required under this subsection to submit to an

 

examination under oath, the person submitted to the examination,

 

subject to all of the following:

 

     (i) The person was provided at least 21 days' notice of the

 

examination.

     (ii) The examination was conducted in a location reasonably

 

convenient for the person.

 

     (iii) Any reasonable request by the person to reschedule the

 

date, time, or location of the examination was accommodated.

 

     (3) The Michigan automobile insurance placement facility may

 

perform its functions and responsibilities under this section and

 

the assigned claims plan directly or through an insurer assigned by

 

the Michigan automobile insurance placement facility to administer

 

the claim on behalf of the Michigan automobile insurance placement

 

facility. The assignment of a claim by the Michigan automobile

 

insurance placement facility to an insurer is not a determination

 

of eligibility under this chapter or the assigned claims plan, and

 

a claim assigned to an insurer by the Michigan automobile insurance

 

placement facility may later be denied if the claim is not eligible

 

under this chapter or the assigned claims plan.

 

     (4) (2) A person who presents or causes to be presented an

 

oral or written statement, including computer-generated

 

information, as part of or in support of a claim to the Michigan

 

automobile insurance placement facility, or to an insurer to which

 

the claim is assigned under the assigned claims plan, for payment

 

or another benefit knowing that the statement contains false

 

information concerning a fact or thing material to the claim

 

commits a fraudulent insurance act under section 4503 that is

 

subject to the penalties imposed under section 4511. A claim that

 

contains or is supported by a fraudulent insurance act as described

 

in this subsection is ineligible for payment or of personal

 

protection insurance benefits under the assigned claims plan.

     (5) The Michigan automobile insurance placement facility may

 

contract with other persons for all or a portion of the goods and

 

services necessary for operating and maintaining the assigned

 

claims plan.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.

 

     Enacting section 2. This amendatory act does not take effect

 

unless Senate Bill No.____ or House Bill No. 4624 (request no.

 

00364'17 **) of the 99th Legislature is enacted into law.