House Bill 1419
By: Representatives Franklin of the 160th, Stephens of the 164th, Ridley of the 6th, Gullett of
the 19th, Gambill of the 15th, and others
A BILL TO BE ENTITLED
AN ACT
To amend Chapters 6 and 34 of Title 33 of the Official Code of Georgia Annotated, relating
to unfair trade practices and motor vehicle accident reparations, respectively, so as to provide
for timely claims processing in supplemental estimates for repairs under motor vehicle
liability insurance policies; to provide for unfair claims settlement practices; to provide for
written explanations; to provide for definitions; to provide for rules and regulations; to
provide for related matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 6 of Title 33 of the Official Code of Georgia Annotated, relating to unfair trade
practices, is amended by revising paragraphs (15) and (16) in Code Section 33-6-34, relating
to unfair claims settlement practices, as follows:
"(15) Failure to comply with any insurer requirement in Chapter 20E of this title, the
'Surprise Billing Consumer Protection Act,' including:
(A) The failure to designate whether the healthcare plan is subject to the exclusive
jurisdiction of the Employee Retirement Income Security Act of 1974, 29 U.S.C. Sec.
1001, et seq.;
(B) The failure to directly pay the provider or facility within 15 working days for
electronic claims or 30 calendar days for paper claims any moneys due under Code
Section 33-20E-4 or 33-20E-5; or
(C) The failure to pay a resolution organization as required under Code
Section 33-20E-16; <del>and
</del> (16) Failure to comply with any insurer requirement relating to emergency services or
care in Article 4 of Chapter 11 of Title 31, Article 1 of Chapter 20A of this title, Chapter
20E of this title, Chapter 21A of this title, Code Section 33-24-59.27, and Chapter 30 of
this title; <ins>and
(17) Failure to comply with any insurer requirement relating to timely claims processing
and supplemental estimates under a motor vehicle liability insurance policy as provided
under Code Section 33-34-10."
</ins> SECTION 2.
Chapter 34 of said title, relating to motor vehicle accident reparations, is amended by adding
a new Code section to read as follows:
<ins>"33-34-10.
(a) As used in this Code section, the term:
(1) 'Appraiser' means any person evaluating motor vehicle damage and determining the
cost of parts and labor required to repair such damage.
(2) 'Claimant' means either a first-party claimant or insured or a third-party claimant who
asserts a claim for payment, benefits, reimbursement, or damages under a motor vehicle
liability insurance policy arising out of, based on, or in any way related to a motor vehicle
collision, loss, ownership, maintenance, or use. Such term includes any assignee,
subrogee, or legal representative of a first-party claimant or third-party claimant to the
extent such assignee, subrogee, or legal representative asserts the claim.
</ins>
<ins>(3) 'Motor vehicle liability insurance' means motor vehicle insurance that covers the use
of a motor vehicle and its operating equipment; covers liability, collision, comprehensive,
personal injury protection or medical payments, or uninsured or underinsured motorist
protection; or provides the mandatory minimum limits required under this chapter for the
personal use of a private passenger automobile. Such term includes coverage provided
through an approved plan or certificate of self-insurance to the extent recognized under
state law as satisfying such minimum limits.
(4) 'Repair facility' means a motor vehicle dealer, garage, body shop, or other
commercial entity which undertakes the repair or replacement of parts of a motor vehicle,
including, but not limited to, frames, doors, bumpers, and paint.
(5) 'Supplemental damage' means additional physical damage to a motor vehicle that was
not visible or reasonably ascertainable at the time of the original inspection or appraisal
and is discovered after the initial insurance claim or estimated repair cost is filed.
(6) 'Supplemental estimate' means a written estimate for supplemental damage prepared
by an appraiser.
(b) An insurer providing coverage under a motor vehicle liability insurance policy shall
promptly acknowledge and investigate claims of supplemental damage submitted by a
repair facility or claimant by meeting at least the following requirements:
(1) Within one business day of a notification of supplemental damage and supplemental
estimate, the insurer shall assign an appraiser to inspect the damaged motor vehicle in
person or review the supplemental estimate; and
(2) Within three business days of a notification of supplemental damage and
supplemental estimate, the insurer shall complete an inspection of the damaged motor
vehicle in person or review the supplemental estimate and provide a written response;
provided, however, that the time for inspection or review may be extended for an
additional three business days if unforeseen circumstances make inspection or review
within three business days impracticable, provided that the insurer notifies the repair
</ins>
<ins>facility and claimant of the specific unforeseen circumstance that necessitates such
extension.
(c) Within ten business days of receipt of a notification of supplemental damage and
supplemental estimate, an insurer shall provide a repair facility and claimant with a written
decision indicating the line items, parts, or operations that are approved and authorized for
payment; those that are denied, reduced, or altered from the supplemental estimate; and a
written explanation for such denial, reduction, or alteration, including, but not limited to,
policy coverage limitations, prior payment, duplication, or unrelated to loss. No insurer
shall issue payment or settlement for a supplemental estimate without such written decision
and explanation.
(d) A violation of this Code section that occurs with such frequency as to constitute a
general business practice shall be a violation of Article 2 of Chapter 6 of this title, the
'Unfair Claims Settlement Practices Act.'
(e) The Commissioner shall promulgate rules and regulations necessary to implement this
Code section, which may include, but shall not be limited to, prescribing uniform
supplemental estimate and written explanation forms."
</ins> SECTION 3.
All laws and parts of laws in conflict with this Act are repealed.