Bill Summary for Bill Number HB10-1234

Date: 03/08/2010

Final
BILL SUMMARY for HB10-1234

HOUSE COMMITTEE ON JUDICIARY

Votes: View-->	Action Taken:
Adopt prepared amendment L.002 (Attachment A). Th Refer House Bill 10-1234, as amended, to the Commi	Pass Without Objection PASS

01:36 PM -- House Bill 10-1234

Representative Primavera, prime sponsor, presented House Bill 10-1234 concerning the fair settlement of claims for benefits under an insurance policy. Under current law, a first-party claimant whose claims for benefits under an insurance policy have been delayed or denied without a reasonable basis can be awarded attorney fees, court costs, and double benefits. This bill extends these remedies to third-party claimants whose claims for medical benefits or requests for authorization for medical services against an insured under a liability policy are denied or delayed unreasonably.

For first- and third-party claims, unreasonableness is presumed when an insurer denies or delays the payment of a claim based on a decision made by a person not licensed in good standing in Colorado or in active clinical practice in the same specialty as the claim or requested medical service.

Representative Primavera explained the bill and prepared amendment L.002 (Attachment A).

01:42 PM -- Marc Reece, Colorado Association of Health Plans, spoke in opposition to the bill. Mr. Reece indicated that current law provides sufficient mechanisms for covered individuals to get a fair and complete review of any denied claims. He discussed ways in which the bill would hamper the ability of insurance companies to review claims. He stated that the bill will hurt the objectivity of physicians in the review process. Mr. Reece responded to questions from the committee about the review of denied claims and ways in which the bill could hurt Colorado consumers. The committee had a lengthy discussion about the review of claims by specialists.

01:57 PM -- Tara Reilly, State Farm, spoke in opposition to the bill. Ms. Reilly stated that the bill will significantly delay and complicate the claims review process by requiring the input of an independent medical examiner. She indicated that the bill is likely to raise insurance premiums. She spoke to existing remedies for covered individuals who believe their claims have been improperly denied. Ms. Reilly responded to questions from the committee about claims that are denied because they are not related to an auto accident.

02:03 PM -- Jeff Ruebel, Colorado Defense Lawyers' Association, spoke in opposition to the bill. Mr. Ruebel stated that the bill is contrary to the United States' system of jurisprudence. He discussed the use of common sense and credibility by insurance adjusters. He responded to questions from the committee about the review of denied claims.

02:10 PM -- Betty Lehman, representing herself, spoke in support of the bill. Ms. Lehman discussed her experience with the process of appealing denied claims. She distributed a letter from the American Academy of Pediatrics about autism (Attachment B). She stated that the review process is a sham. She indicated that costs have not increased in other states with this kind of law.

02:14 PM -- Aaron Segel, Colorado Public Interest Research Group (CoPIRG), spoke in support of the bill. Mr. Segel stated that it is unfair to have individuals making critical care decisions who are not relatively qualified to make such decisions. He discussed examples of medical claims that were denied by individuals without the proper medical background.

02:17 PM -- Melissa Collins, Colorado Chiropractic Association, spoke in support of the bill. Ms. Collins listed a number of organizations that support the bill. She stated that the practice of summarily denying medical claims harms patients. She addressed comments made by prior witnesses.

02:21 PM -- Bob Epstein, Colorado Senior Lobby, spoke in support of the bill. Mr. Epstein spoke to the need for patients to get the health care recommended by their physicians in a timely manner without a lengthy appeals process. He discussed his experience appealing a denied claim.

02:24 PM -- Representative Gwyn Green, representing herself, spoke in support of the bill. Representative Green discussed her experience as a social worker. She provided examples of clients who were denied medical care by insurance company claims reviewers.

02:29 PM

Representative Primavera wrapped up her presentation of the bill.


BILL:	HB10-1234
TIME:	02:29:52 PM
MOVED:	Court
MOTION:	Adopt prepared amendment L.002 (Attachment A). The motion passed without objection.
SECONDED:
		VOTE
	Court
	Gardner B.
	Kagan
	King S.
	Miklosi
	Nikkel
	Pace
	Ryden
	Waller
	McCann
	Levy

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB10-1234
TIME:	02:30:02 PM
MOVED:	Court
MOTION:	Refer House Bill 10-1234, as amended, to the Committee of the Whole with a favorable recommendation. The motion passed on a vote of 6-5.
SECONDED:	Kagan
		VOTE
	Court	Yes
	Gardner B.	No
	Kagan	Yes
	King S.	No
	Miklosi	Yes
	Nikkel	No
	Pace	Yes
	Ryden	Yes
	Waller	No
	McCann	No
	Levy	Yes

Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS