Senate Bill No. 1259

Public Act No. 99-59

An Act Concerning the Marketing of Insurance.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subdivision (21) of section 38a-567 of the general statutes is repealed and the following is substituted in lieu thereof:

(21) Any violation of subdivisions (10) to (16), inclusive, and any regulations established under subdivision (17) of this section shall be an unfair and prohibited practice under sections 38a-815 to [38a-831] 38a-830, inclusive.

Sec. 2. Subdivision (15) of section 38a-816 of the general statutes is repealed and the following is substituted in lieu thereof:

(15) Failure to pay accident and health claims, including, but not limited to, claims for payment or reimbursement to health care providers, within forty-five days, or as otherwise stipulated by contract, of receipt by an insurer of the claimant's proof of loss form or the health care provider's request for payment filed in accordance with the insurer's practices or procedures, unless the Insurance Commissioner determines that a legitimate dispute exists as to coverage, liability or damages or that the claimant has fraudulently caused or contributed to the loss. Any insurer who fails to pay such a claim or request with the forty-five-day period shall pay the claimant or health care provider the amount of such claim plus interest at the rate of fifteen per cent per annum, in addition to any other penalties which may be imposed pursuant to sections 38a-11, 38a-25, 38a-41 to 38a-53, inclusive, 38a-57 to 38a-60, inclusive, 38a-62 to 38a-64, inclusive, 38a-76, 38a-83, 38a-84, 38a-117 to 38a-124, inclusive, 38a-129 to 38a-140, inclusive, 38a-146 to 38a-155, inclusive, 38a-283, 38a-288 to 38a-290, inclusive, 38a-319, 38a-320, 38a-459, 38a-464, 38a-815 to 38a-819, inclusive, 38a-824 to 38a-826, inclusive, and 38a-828 to [38a-831] 38a-830, inclusive. Whenever the interest due a claimant or health care provider pursuant to this section is less than one dollar, the insurer shall deposit such amount in a separate interest-bearing account in which all such amounts shall be deposited. At the end of each calendar year each such insurer shall donate such amount to The University of Connecticut Health Center.

Sec. 3. Subsection (b) of section 38a-832 of the general statutes is repealed and the following is substituted in lieu thereof:

(b) If any insurer or any employee of an insurer makes a written or oral communication in violation of subsection (a) of this section, the Insurance Commissioner, after reasonable notice and an opportunity for a hearing, may impose sanctions pursuant to this title, except sections 38a-815 to [38a-831] 38a-830, inclusive, including, but not limited to, the imposition of civil penalties.

Sec. 4. Section 38a-831 of the general statutes is repealed.

Approved May 27, 1999