Montana Code Annotated 2019

TITLE 20. EDUCATION

CHAPTER 25. UNIVERSITY SYSTEM

Part 13. Group Benefits

Insurance Commissioner Duties -- Independent Reviewer Qualifications

20-25-1320. Insurance commissioner duties -- independent reviewer qualifications. (1) The insurance commissioner shall:

(a) approve any independent reviewer that is eligible to adjudicate disputes under 20-25-1315 through 20-25-1320;

(b) maintain a list of independent reviewers eligible to adjudicate disputes under 20-25-1315 through 20-25-1320;

(c) terminate approval of an independent reviewer and remove the independent reviewer from the list of approved independent reviewers upon determining that an independent reviewer no longer meets the requirements to adjudicate disputes; and

(d) adopt rules necessary to implement 20-25-1315 through 20-25-1320, including rules regarding discovery and other procedures regarding the dispute resolution process and eligibility of an independent reviewer.

(2) An individual is eligible to be an independent reviewer under 20-25-1315 through 20-25-1320 if the individual is knowledgeable and experienced in applicable principles of contract and insurance law.

(3) In approving an individual as an independent reviewer, the insurance commissioner shall ensure that the individual does not have a conflict of interest that would adversely impact the individual's independence and impartiality in rendering a decision in an independent dispute resolution procedure under 20-25-1318 and 20-25-1319. A conflict of interest includes but is not limited to an ownership or direct familial interest in an insurer, a health care provider, or an air ambulance service that may be involved in an independent dispute resolution procedure under 20-25-1318 and 20-25-1319.

(4) In approving an individual as an independent reviewer, the insurance commissioner may not approve an individual who is currently serving in any matter as a hearing officer for the commissioner.

History: En. Sec. 6, Ch. 231, L. 2017.