SF 1547

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to insurance; no-fault auto; regulating 
  1.3             medical examinations requested by reparation obligors; 
  1.4             amending Minnesota Statutes 1996, sections 65B.56, 
  1.5             subdivision 1; and 72A.201, subdivision 6. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 1996, section 65B.56, 
  1.8   subdivision 1, is amended to read: 
  1.9      Subdivision 1.  [MEDICAL EXAMINATIONS AND DISCOVERY OF 
  1.10  CONDITION OF CLAIMANT.] Any person with respect to whose injury 
  1.11  benefits are claimed under a plan of reparation security shall, 
  1.12  upon request of the reparation obligor from whom recovery is 
  1.13  sought, submit to a physical examination by a physician or 
  1.14  physicians selected by the obligor as may reasonably be 
  1.15  required.  The obligor may not select a physician who receives 
  1.16  more than five percent of the physician's total annual revenue 
  1.17  attributable to the practice of medicine from medical 
  1.18  examinations requested by obligors under this section. 
  1.19     The costs of any examinations requested by the obligor 
  1.20  shall be borne entirely by the requesting obligor.  Such 
  1.21  examinations shall be conducted within the city, town, or 
  1.22  statutory city of residence of the injured person.  If there is 
  1.23  no qualified physician to conduct the examination within the 
  1.24  city, town, or statutory city of residence of the injured 
  1.25  person, then such examination shall be conducted at another 
  2.1   place of the closest proximity to the injured person's 
  2.2   residence.  Obligors are authorized to include reasonable 
  2.3   provisions in policies for mental and physical examination of 
  2.4   those injured persons. 
  2.5      If requested by the person examined, A party causing an 
  2.6   examination to be made shall deliver to the examinee a copy of 
  2.7   every written report concerning the examination rendered by an 
  2.8   examining physician to that person, at least one of which 
  2.9   reports must set out in detail the findings and conclusions of 
  2.10  such examining physician and include a certification by the 
  2.11  physician, under penalty of perjury, that the physician receives 
  2.12  no more than five percent of total annual revenue attributable 
  2.13  to the practice of medicine from medical examinations requested 
  2.14  by obligors under this section. 
  2.15     An injured person shall also do all things reasonably 
  2.16  necessary to enable the obligor to obtain medical reports and 
  2.17  other needed information to assist in determining the nature and 
  2.18  extent of the injured person's injuries and loss, and the 
  2.19  medical treatment received.  If the claimant refuses to 
  2.20  cooperate in responding to requests for examination and 
  2.21  information as authorized by this section, evidence of such 
  2.22  noncooperation shall be admissible in any suit or arbitration 
  2.23  filed for damages for such personal injuries or for the benefits 
  2.24  provided by sections 65B.41 to 65B.71. 
  2.25     The provisions of this section apply before and after the 
  2.26  commencement of suit. 
  2.27     Sec. 2.  Minnesota Statutes 1996, section 72A.201, 
  2.28  subdivision 6, is amended to read: 
  2.29     Subd. 6.  [STANDARDS FOR AUTOMOBILE INSURANCE CLAIMS 
  2.30  HANDLING, SETTLEMENT OFFERS, AND AGREEMENTS.] In addition to the 
  2.31  acts specified in subdivisions 4, 5, 7, 8, and 9, the following 
  2.32  acts by an insurer, adjuster, or a self-insured or 
  2.33  self-insurance administrator constitute unfair settlement 
  2.34  practices:  
  2.35     (1) if an automobile insurance policy provides for the 
  2.36  adjustment and settlement of an automobile total loss on the 
  3.1   basis of actual cash value or replacement with like kind and 
  3.2   quality and the insured is not an automobile dealer, failing to 
  3.3   offer one of the following methods of settlement:  
  3.4      (a) comparable and available replacement automobile, with 
  3.5   all applicable taxes, license fees, at least pro rata for the 
  3.6   unexpired term of the replaced automobile's license, and other 
  3.7   fees incident to the transfer or evidence of ownership of the 
  3.8   automobile paid, at no cost to the insured other than the 
  3.9   deductible amount as provided in the policy; 
  3.10     (b) a cash settlement based upon the actual cost of 
  3.11  purchase of a comparable automobile, including all applicable 
  3.12  taxes, license fees, at least pro rata for the unexpired term of 
  3.13  the replaced automobile's license, and other fees incident to 
  3.14  transfer of evidence of ownership, less the deductible amount as 
  3.15  provided in the policy.  The costs must be determined by:  
  3.16     (i) the cost of a comparable automobile, adjusted for 
  3.17  mileage, condition, and options, in the local market area of the 
  3.18  insured, if such an automobile is available in that area; or 
  3.19     (ii) one of two or more quotations obtained from two or 
  3.20  more qualified sources located within the local market area when 
  3.21  a comparable automobile is not available in the local market 
  3.22  area.  The insured shall be provided the information contained 
  3.23  in all quotations prior to settlement; or 
  3.24     (iii) any settlement or offer of settlement which deviates 
  3.25  from the procedure above must be documented and justified in 
  3.26  detail.  The basis for the settlement or offer of settlement 
  3.27  must be explained to the insured; 
  3.28     (2) if an automobile insurance policy provides for the 
  3.29  adjustment and settlement of an automobile partial loss on the 
  3.30  basis of repair or replacement with like kind and quality and 
  3.31  the insured is not an automobile dealer, failing to offer one of 
  3.32  the following methods of settlement:  
  3.33     (a) to assume all costs, including reasonable towing costs, 
  3.34  for the satisfactory repair of the motor vehicle.  Satisfactory 
  3.35  repair includes repair of both obvious and hidden damage as 
  3.36  caused by the claim incident.  This assumption of cost may be 
  4.1   reduced by applicable policy provision; or 
  4.2      (b) to offer a cash settlement sufficient to pay for 
  4.3   satisfactory repair of the vehicle.  Satisfactory repair 
  4.4   includes repair of obvious and hidden damage caused by the claim 
  4.5   incident, and includes reasonable towing costs; 
  4.6      (3) regardless of whether the loss was total or partial, in 
  4.7   the event that a damaged vehicle of an insured cannot be safely 
  4.8   driven, failing to exercise the right to inspect automobile 
  4.9   damage prior to repair within five business days following 
  4.10  receipt of notification of claim.  In other cases the inspection 
  4.11  must be made in 15 days; 
  4.12     (4) regardless of whether the loss was total or partial, 
  4.13  requiring unreasonable travel of a claimant or insured to 
  4.14  inspect a replacement automobile, to obtain a repair estimate, 
  4.15  to allow an insurer to inspect a repair estimate, to allow an 
  4.16  insurer to inspect repairs made pursuant to policy requirements, 
  4.17  or to have the automobile repaired; 
  4.18     (5) regardless of whether the loss was total or partial, if 
  4.19  loss of use coverage exists under the insurance policy, failing 
  4.20  to notify an insured at the time of the insurer's acknowledgment 
  4.21  of claim, or sooner if inquiry is made, of the fact of the 
  4.22  coverage, including the policy terms and conditions affecting 
  4.23  the coverage and the manner in which the insured can apply for 
  4.24  this coverage; 
  4.25     (6) regardless of whether the loss was total or partial, 
  4.26  failing to include the insured's deductible in the insurer's 
  4.27  demands under its subrogation rights.  Subrogation recovery must 
  4.28  be shared at least on a proportionate basis with the insured, 
  4.29  unless the deductible amount has been otherwise recovered by the 
  4.30  insured, except that when an insurer is recovering directly from 
  4.31  an uninsured third party by means of installments, the insured 
  4.32  must receive the full deductible share as soon as that amount is 
  4.33  collected and before any part of the total recovery is applied 
  4.34  to any other use.  No deduction for expenses may be made from 
  4.35  the deductible recovery unless an attorney is retained to 
  4.36  collect the recovery, in which case deduction may be made only 
  5.1   for a pro rata share of the cost of retaining the attorney.  An 
  5.2   insured is not bound by any settlement of its insurer's 
  5.3   subrogation claim with respect to the deductible amount, unless 
  5.4   the insured receives, as a result of the subrogation settlement, 
  5.5   the full amount of the deductible.  Recovery by the insurer and 
  5.6   receipt by the insured of less than all of the insured's 
  5.7   deductible amount does not affect the insured's rights to 
  5.8   recover any unreimbursed portion of the deductible from parties 
  5.9   liable for the loss; 
  5.10     (7) requiring as a condition of payment of a claim that 
  5.11  repairs to any damaged vehicle must be made by a particular 
  5.12  contractor or repair shop or that parts, other than window 
  5.13  glass, must be replaced with parts other than original equipment 
  5.14  parts; 
  5.15     (8) where liability is reasonably clear, failing to inform 
  5.16  the claimant in an automobile property damage liability claim 
  5.17  that the claimant may have a claim for loss of use of the 
  5.18  vehicle; 
  5.19     (9) failing to make a good faith assignment of comparative 
  5.20  negligence percentages in ascertaining the issue of liability; 
  5.21     (10) failing to pay any interest required by statute on 
  5.22  overdue payment for an automobile personal injury protection 
  5.23  claim; 
  5.24     (11) if an automobile insurance policy contains either or 
  5.25  both of the time limitation provisions as permitted by section 
  5.26  65B.55, subdivisions 1 and 2, failing to notify the insured in 
  5.27  writing of those limitations at least 60 days prior to the 
  5.28  expiration of that time limitation; 
  5.29     (12) if an insurer chooses to have an insured examined as 
  5.30  permitted by section 65B.56, subdivision 1, failing to notify 
  5.31  the insured of all of the insured's rights and obligations under 
  5.32  that statute, including the right to request, in writing, and to 
  5.33  receive a copy of the report of the examination that includes 
  5.34  the certification by the examining physician required under that 
  5.35  section; 
  5.36     (13) failing to provide, to an insured who has submitted a 
  6.1   claim for benefits described in section 65B.44, a complete copy 
  6.2   of the insurer's claim file on the insured, excluding internal 
  6.3   company memoranda, all materials that relate to any insurance 
  6.4   fraud investigation, materials that constitute attorney 
  6.5   work-product or that qualify for the attorney-client privilege, 
  6.6   and medical reviews that are subject to section 145.64, within 
  6.7   ten business days of receiving a written request from the 
  6.8   insured.  The insurer may charge the insured a reasonable 
  6.9   copying fee.  This clause supersedes any inconsistent provisions 
  6.10  of sections 72A.49 to 72A.505; 
  6.11     (14) if an automobile policy provides for the adjustment or 
  6.12  settlement of an automobile loss due to damaged window glass, 
  6.13  failing to assume all reasonable costs sufficient to pay the 
  6.14  insured's chosen vendor for the repair or replacement of 
  6.15  comparable window glass.  This clause does not prohibit an 
  6.16  insurer from recommending a vendor to the insured or from 
  6.17  agreeing with a vendor to perform work at an agreed-upon price, 
  6.18  provided, however, that before recommending a vendor, the 
  6.19  insurer shall offer its insured the opportunity to choose the 
  6.20  vendor; 
  6.21     (15) requiring that the repair or replacement of motor 
  6.22  vehicle glass and related products and services be made in a 
  6.23  particular place or shop or by a particular entity, or by 
  6.24  otherwise limiting the ability of the insured to select the 
  6.25  place, shop, or entity to repair or replace the motor vehicle 
  6.26  glass and related products and services; or 
  6.27     (16) engaging in any act or practice of intimidation, 
  6.28  coercion, threat, incentive, or inducement for or against an 
  6.29  insured to use a particular company or location to provide the 
  6.30  motor vehicle glass repair or replacement services or products.  
  6.31  For purposes of this section, a warranty shall not be considered 
  6.32  an inducement or incentive. 
  6.33     Sec. 3.  [EFFECTIVE DATE.] 
  6.34     Sections 1 and 2 are effective August 1, 1997, and apply to 
  6.35  medical examinations conducted on or after that date.