HF 2339

as introduced - 89th Legislature (2015 - 2016) Posted on 05/15/2015 09:16am

A bill for an act
relating to commerce; regulating insurance fraud; regulating the wrongful
detaining, suspending, or denying of no-fault auto benefits; amending Minnesota
Statutes 2014, sections 45.0135, subdivisions 2b, 8; 65B.54, subdivision 2;
proposing coding for new law in Minnesota Statutes, chapter 65B.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2014, section 45.0135, subdivision 2b, is amended to read:

Subd. 2b.

Duties.

The Commerce Fraud Bureau shall:

(1) review notices and reports of insurance fraud submitted by authorized insurers,
their employees, and agents or producers new text begin , as well as by insureds, beneficiaries, and
providers of goods and services including without limit health care providers and attorneys new text end ;

(2) respond to notifications or complaints of suspected insurance fraud generated by
other law enforcement agencies, state or federal governmental units, or any other person;

(3) initiate inquiries and conduct investigations when the bureau has reason to
believe that insurance fraud has been or is being committed; and

(4) report incidents of alleged insurance fraud disclosed by its investigations to
appropriate law enforcement agencies, including, but not limited to, the attorney general,
county attorneys, or any other appropriate law enforcement or regulatory agency, and shall
assemble evidence, prepare charges, and otherwise assist any law enforcement authority
having jurisdiction.

Sec. 2.

Minnesota Statutes 2014, section 45.0135, subdivision 8, is amended to read:

Subd. 8.

Investigations; deleted text begin health-related deleted text end new text begin professional or commercial licensing
new text end boards.

(a) The Commerce Fraud Bureau may consult with the appropriate deleted text begin health-related
deleted text end new text begin professional and commercial licensing new text end board when a licensee, licensed under deleted text begin chapter
144E, 147, 148, 148B, or 150A deleted text end new text begin state law new text end , is suspected of insurance fraud.

(b) The bureau shall, for any conviction involving or related to insurance, send
copies of all public data in its possession to the appropriate deleted text begin health-related deleted text end new text begin professional
or commercial new text end licensing board.

Sec. 3.

Minnesota Statutes 2014, section 65B.54, subdivision 2, is amended to read:

Subd. 2.

deleted text begin Interest on deleted text end new text begin Liability for new text end overdue payments.

deleted text begin Overdue payments shall
bear simple interest at the rate of 15 percent per annum deleted text end new text begin If a reparations obligor is liable
for basic economic loss benefits, the reparations obligor is liable to pay, in addition to the
amount of the claim, interest on the amount of the claim at the rate set forth under section
62Q.75 as damages together with reasonable attorney fees new text end .

Sec. 4.

new text begin [65B.6051] ABUSE PREVENTION.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section:
new text end

new text begin (1) "abusive act" means an act by (i) a reparations obligor, attorney, service provider,
supplier, insured, claimant, or beneficiary; and (ii) an entity or person who acts at the
direction of, or in cooperation with, an entity or person set forth in item (i) when the entity
or person knows or has reason to know that the purpose of the act is to wrongfully obtain,
suspend, or deny benefits under this chapter; and
new text end

new text begin (2) "informant" means a qualified person or entity who provides the primary specific
evidence or information in support of one or more violations under this section, taking into
account the significance of the evidence or information. The term does not include any
person or entity bringing an action under this section or acting on behalf of the news media.
new text end

new text begin Subd. 2. new text end

new text begin Use of nonstate financial resources. new text end

new text begin In an investigation or prosecution by
the state for an abusive act, a nongovernmental entity including an insurance carrier may
provide the financial resources necessary for conducting the investigation and prosecution.
new text end

new text begin Subd. 3. new text end

new text begin Whistleblowers. new text end

new text begin (a) Without limiting an insurer's right of full recovery
of proceeds paid for claims deemed noncompensable as arising from an abusive act, the
court may also award those sums deemed appropriate, but in no case more than 37 percent
of proceeds to be recovered or saved by the insurer with respect to the abusive act.
new text end

new text begin (b) An insurer may elect to reimburse, including on a prepayment basis or otherwise,
reasonable out-of-pocket costs of an actual or potential informant that are incurred or
likely to be incurred in the course of preparing and disclosing the information. These
out-of-pocket costs include without limit any applicable attorney fees associated with the
preparation and disclosure of the information by the informant.
new text end

new text begin (c) An actual or potential informant may place conditions on the use and disclosure of
the information. The conditions may include without limit confidentiality as to the identity
of the informant, as well as the nature of any reimbursement terms, restrictions on the scope
of individuals and entities with whom the insurer may properly disclose the information,
assistance in the determination of the scope of the insurer's investigation or efforts to
prosecute, and other conditions relating to the use and disclosure of the information.
new text end

new text begin (d) Unless otherwise requested by the informant, all information provided by an
informant, including any restriction on use and disclosure, if presented in court, must be
examined in a confidential, in-camera proceeding, unless the informant requests a hearing
in open court and the court determines that a public hearing is necessary to the public
interest and the proper administration of justice.
new text end

new text begin (e) In the absence of actual malice, no person or entity furnishing, disclosing, or
requesting information under this section is subject to civil liability for libel, slander,
or any other cause of action arising from the furnishing, disclosing, or requesting of
information. A person or entity against whom an action is brought who is found to be
immune from liability under this section may recover reasonable attorney fees and costs
from the person or party who brought the action. This section does not abrogate or modify
in any way any common law or statutory privilege or immunity otherwise enjoyed by a
person or entity. Without limiting the terms of this subdivision, an insurer may:
new text end

new text begin (1) notify any change of representation or treating health care provider to state and
federal agencies, prior attorneys of record, prior treating providers of record, and the
patient or client, and to discuss the change with such persons or entities; and
new text end

new text begin (2) request an explanation of circumstances of change of treating provider and
attorney to the subsequent treating provider and attorney or the patient or client.
new text end

new text begin Notwithstanding clause (2): (i) the payment of any benefits relating to the patient shall
not be suspended or conditioned upon the failure of the subsequent treating provider or
attorney to respond to the request or provide such explanation; and (ii) the request shall
clearly and conspicuously state that the payment of benefits shall not be suspended or
conditioned upon a response or explanation.
new text end

new text begin Subd. 4. new text end

new text begin Private cause of action. new text end

new text begin In addition to any other private remedy provided
by law, any person or entity that sustains economic damages or commercial injury as a
result of any violation of this section may bring an action for appropriate injunctive or
other equitable relief, actual damages, if any, sustained by reason of the violation, taxable
costs, and other damages specified under this section, including without limit attorney
fees. Notwithstanding the foregoing and without limiting any other remedies that may be
available under other law, no private cause of action exists under this section against a
reparations obligor for an abusive act allegedly committed by a reparations obligor.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2015, and applies to
abusive acts committed before, on, or after that date.
new text end