May 17, 2017, Introduced by Rep. Whiteford and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending section 3173a (MCL 500.3173a), as amended by 2012 PA
204.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3173a. (1) The Michigan automobile insurance placement
facility shall review a claim for personal protection insurance
benefits under the assigned claims plan, shall make an initial
determination
of a claimant's the eligibility for benefits under
this
chapter and the assigned claims plan, and
shall deny an
obviously
ineligible a claim . The that
the Michigan automobile
insurance placement facility determines is ineligible under this
chapter or the assigned claims plan. If a claimant or person making
a claim through or on behalf of a claimant fails to cooperate with
the Michigan automobile insurance placement facility as required by
subsection (2), the claimant or person is ineligible for benefits
under the assigned claims plan. The Michigan automobile insurance
placement facility shall promptly notify in writing the claimant
shall
be notified promptly in writing and
any person that submitted
a
claim through or on behalf of a claimant of
the a denial and the
reasons for the denial.
(2) A claimant or a person making a claim through or on behalf
of a claimant shall cooperate with the Michigan automobile
insurance placement facility in its determination of eligibility
and the settlement or defense of any claim or suit, including, but
not limited to, submitting to an examination under oath and
compliance with sections 3151 to 3153. There is a rebuttable
presumption that a person has satisfied the duty to cooperate under
this section if all of the following apply:
(a) The person submitted a claim for personal protection
insurance benefits under the assigned claims plan by submitting to
the Michigan automobile insurance placement facility a complete
application on a form provided by the Michigan automobile insurance
placement facility in accordance with the assigned claims plan.
(b) The person provided satisfactory proof of loss under the
assigned claims plan as described in section 3172.
(c) If required under this subsection to submit to an
examination under oath, the person submitted to the examination,
subject to all of the following:
(i) The person was provided at least 21 days' notice of the
examination.
(ii) The examination was conducted in a location reasonably
convenient for the person.
(iii) Any reasonable request by the person to reschedule the
date, time, or location of the examination was accommodated.
(3) The Michigan automobile insurance placement facility may
perform its functions and responsibilities under this section and
the assigned claims plan directly or through an insurer assigned by
the Michigan automobile insurance placement facility to administer
the claim on behalf of the Michigan automobile insurance placement
facility. The assignment of a claim by the Michigan automobile
insurance placement facility to an insurer is not a determination
of eligibility under this chapter or the assigned claims plan, and
a claim assigned to an insurer by the Michigan automobile insurance
placement facility may later be denied if the claim is not eligible
under this chapter or the assigned claims plan.
(4) (2)
A person who presents or causes to
be presented an
oral or written statement, including computer-generated
information, as part of or in support of a claim to the Michigan
automobile insurance placement facility, or to an insurer to which
the claim is assigned under the assigned claims plan, for payment
or another benefit knowing that the statement contains false
information concerning a fact or thing material to the claim
commits a fraudulent insurance act under section 4503 that is
subject to the penalties imposed under section 4511. A claim that
contains or is supported by a fraudulent insurance act as described
in
this subsection is ineligible for payment or of personal
protection insurance benefits under the assigned claims plan.
(5) The Michigan automobile insurance placement facility may
contract with other persons for all or a portion of the goods and
services necessary for operating and maintaining the assigned
claims plan.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.
Enacting section 2. This amendatory act does not take effect
unless Senate Bill No.____ or House Bill No. 4624 (request no.
00364'17 **) of the 99th Legislature is enacted into law.