Bill > SB1607

This bill establishes a Health Care Claims Consumer Assistance Program within the Department of Insurance and Financial Institutions to help individuals enrolled in or seeking health insurance by assisting with filing complaints and appeals, resolving disputes and denied claims with health insurers, and educating consumers about their rights. The bill also introduces significant penalties for health insurers that repeatedly violate health plan terms, including civil penalties of at least $25,000 for each wrongfully denied or underpaid claim, and mandates that insurers pay double the amount of any wrongfully denied or underpaid claim, plus attorney fees, and potentially additional damages based on the severity of harm to the policyholder. Furthermore, the department will collect data on denied and wrongfully denied claims, adjust penalty amounts annually based on premium rate changes and inflation, and publish an annual report detailing claim denial statistics and investigation outcomes on its website and providing it to state officials. The bill also includes an appropriation of $250,000 for the program and defines key terms such as "consumer," "enrolled," "health care plan," "insured," and "insurer."

Budget and Finance

https://apps.azleg.gov/BillStatus/BillOverview/85239