Bill > H937

This bill aims to increase fairness in insurance by prohibiting insurers from using certain discretionary authority that could lead to less favorable interpretations of policy terms for policyholders in Massachusetts. Specifically, it states that any provision in an insurance policy, contract, or agreement for life, health, annuities, accident, long-term care, or disability insurance that gives the insurer or its agent the power to decide eligibility for benefits, interpret policy language, or set interpretation standards that conflict with Massachusetts law is void and cannot be enforced. "Discretionary authority" is defined as a policy provision that allows an insurer or claim administrator to have broad power in determining benefit entitlement or interpreting policy language, which could result in courts giving deference to the insurer's decisions. The bill also clarifies that insurers can still explain their routine operations and how they apply contract terms, as long as these explanations do not allow for a deferential standard of review by courts. Furthermore, the Commissioner of Insurance will not approve any health, life, or disability policy for use in Massachusetts if it contains such discretionary authority, inconsistent interpretation standards, misleading clauses, or fails to comply with Massachusetts law. The bill also includes a severability clause, meaning that if any part of it is found to be illegal or unenforceable, the rest of the bill will still apply.