House Bill No. 473
Introduced By _______________________________________________________________________________
A Bill for an Act entitled: "An Act requiring that a provider of a disability insurance policy, an insurance certificate, or a membership contract related to health care services inform a customer orally and in writing within 24 hours of a customer's request for information about whether a medical service or procedure is covered by insurance or the terms of the insurance certificate or membership contract and the relevant dollar amount of coverage; requiring an explanation to the customer within 24 hours if coverage information is not available; and amending section
Be it enacted by the Legislature of the State of Montana:
NEW SECTION. Section 1. Coverage information on request. (1) A provider of a disability insurance policy, a certificate of insurance, or a membership contract related to health care services shall provide to a customer by oral communication within 24 hours of the customer's request the following information:
(a) whether a medical service or procedure specified by the customer is covered by the customer's disability insurance policy, certificate of insurance, or membership contract; and
(b) if the medical service or procedure is covered by the policy, certificate, or contract, the dollar amount of the coverage.
(2) If the provider of a disability insurance policy, a certificate of insurance, or a membership contract is unable to meet the requirements in subsection (1), the provider shall inform the customer by oral communication within 24 hours of the customer's request for information why the provider is unable to meet the requirements in subsection (1).
(3) The provider of a disability insurance policy, a certificate of insurance, or a membership contract shall issue in writing and send by mail or electronic means within 24 hours of the customer's request the same information supplied orally to an insured person in compliance with subsection (1) or (2).
Section 2. Section 33-22-101, MCA, is amended to read:
"33-22-101. Exceptions to scope. Parts 1 through 4 of this chapter, except [section 1], 33-22-107, 33-22-110, 33-22-111, 33-22-114, 33-22-125, 33-22-130 through 33-22-132, 33-22-243, and 33-22-304, do not apply to or affect:
(1) any policy of liability or workers' compensation insurance with or without supplementary expense coverage;
(2) any group or blanket policy;
(3) life insurance, endowment, or annuity contracts or supplemental contracts that contain only those provisions relating to disability insurance as:
(a) provide additional benefits in case of death or dismemberment or loss of sight by accident or accidental means; or
(b) operate to safeguard contracts against lapse or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract;
NEW SECTION. Section 3. Codification instruction. [Section 1] is intended to be codified as an integral part of Title 33, and the provisions of Title 33 apply to [section 1].