HB 1420: Insurance; original equipment manufacturer repair procedures for repairs under motor vehicle liability insurance policies; provide

House Bill 1420

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 original equipment manufacturer repair procedures for repairs under motor vehicle liability insurance policies; to provide for unfair claims settlement practices; 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; and

(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; and

(17) Failure to comply with any insurer requirement relating to original equipment manufacturer repair procedures under motor vehicle liability insurance policies as provided under Code Section 33-34-10."

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:

"33-34-10.

(a) As used in this Code section, the term:

(1) '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.

(2) '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.

(3) 'Original equipment manufacturer repair procedure' means any written, electronic, or published repair standard, procedure, specification, or directive issued by a motor vehicle's original equipment manufacturer, including, but not limited to, body, frame, structural, mechanical, electronic, scanning, calibration, and refinishing operations.

(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.

(b) All policies of motor vehicle liability insurance shall provide for all repairs to be made in accordance with the applicable original equipment manufacturer repair procedures.

(c) No insurer that issues, delivers, issues for delivery, or renews a motor vehicle liability insurance policy shall require a claimant to deviate from or deny, omit, or disregard original equipment manufacturer repair procedures.

(d) An insurer that issues, delivers, issues for delivery, or renews a motor vehicle liability insurance policy shall:

(1) Approve any original equipment manufacturer repair procedure that is documented in a written estimate or supplemental estimate from a repair facility or in a written request from a repair facility or claimant when the applicable original equipment manufacturer service publication, position statement, or procedure is identified; and

(2) Only deny reimbursement for a documented original equipment manufacturer repair procedure if, within three business days of receipt of the written estimate, supplemental estimate, or written request provided for in paragraph (1) of this subsection, such insurer provides to the claimant:

(A) A written itemized explanation for such denial, including, but not limited to, policy coverage limitations, prior payment, duplication, or unrelated to loss, specific to the original equipment manufacturer repair procedure; and

(B) Notice that such denial might constitute an unfair claims settlement practice under state law.

(e) 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.'

(f) The Commissioner shall promulgate rules and regulations necessary to implement this Code section."

SECTION 3.

All laws and parts of laws in conflict with this Act are repealed.