H1129 — An Act to conform private with public subrogation policy

Summary

An Act to conform private with public subrogation policy

Bill Text

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The bill limits the ability of health maintenance organizations and insurers to claim reimbursement from damages awarded to injured persons.

• Chapter 111, section 70D

  Notwithstanding the provisions of section 70A through 70D of this chapter, and notwithstanding any contractual term to the contrary, no health maintenance organization or group or individual medical insurer or disability insurer which has provided benefits for covered services to a person insured in an accident shall have a lien or right of reimbursement or subrogation claim or claims of recoupment no matter how designated upon any recovery or sum had or collected or to be collected, whether by judgment or by settlement or compromise from another person as damages on account of such injuries, for more than the proportionate share of said recovery or sum subject to its lien, right or reimbursement, subrogation claim or claims of recoupment which the amount of benefits so provided for covered services bears to the complete value of the injured persons tort damages. Either the entity which provided benefits or the injured person may petition the court in which the accident case is pending, or in a court in which such case could be properly filed had settlement not been attained before commencement of suit, for a determination of the reasonableness of the settlement and the fair allocation of amounts payable thereunder. A hearing on such petition shall adhere to the same procedural requirement as are provided in section 15 of chapter 152 of the General Laws.

  This addition restricts insurers from claiming more than their proportionate share of damages when seeking reimbursement after an injury-related settlement.

Sponsors

• Marjorie C. Decker · Primary

Subjects