96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB3639


 
Introduced 2/24/2009, by Rep. Karen May
 
SYNOPSIS AS INTRODUCED:
 		
















215 ILCS 5/357.9
  from Ch. 73, par. 969.9


215 ILCS 5/357.9a
  from Ch. 73, par. 969.9a







    Amends the Illinois Insurance Code. Makes changes in the Section concerning the "time of payment of claims" provision required in each accident and health policy.  With respect to the requirement that all claims and indemnities payable under the terms of a policy of accident and health insurance be paid within 30 days following receipt by the insurer of due proof of loss, provides that the policy of accident and health insurance includes both individual and group insurance against disablement or loss of time.  Makes a change concerning application to a group policy of dental insurance.  In the Section concerning a delay in payment of claims, provides that periodic payments of accrued indemnities for disablement or for loss-of-time coverage under both individual and group accident and health policies, as well as payment of accrued indemnity under any individual or group life or accidental death policy (instead of periodic payments of accrued indemnities for loss-of-time coverage under accident and health policies), shall commence not later than 30 days after the receipt by the company of the required written proof of loss.
















LRB096 10057 RPM 20222 b

















 


 


A BILL FOR









 











HB3639

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    AN ACT concerning insurance.

 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:


 
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    Section 5. The Illinois Insurance Code is amended  by 
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changing Sections 357.9 and 357.9a as follows:
 



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    (215 ILCS 5/357.9)  (from Ch. 73, par. 969.9)



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    Sec. 357.9. "TIME OF PAYMENT OF CLAIMS: Indemnities
payable 
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under
this policy for any loss other than loss for which this 
9
policy provides
any periodic payment will be paid immediately 
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upon receipt of due
written proof of such loss.
Subject
to due 
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written proof of loss, all
accrued indemnities for loss for 
12
which this policy provides periodic
payment will be paid ....

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(insert period for payment which must not be
less frequently 
14
than monthly) and any balance remaining unpaid upon the

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termination of liability, will be paid immediately upon receipt 
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of due
written proof."

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    All claims and indemnities payable under the terms of
a 
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policy of accident and health insurance, including both 
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individual and group insurance against disablement or loss of 
20
time, shall be paid within 30 days
following receipt by the 
21
insurer of due proof of loss.
Failure to pay
within such period 
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shall entitle the insured
to interest at the rate of 9
per cent 
23
per annum from the 30th day after receipt of such proof of loss 
 


 






HB3639
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to
the date of late payment, provided that interest amounting 
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to less than one
dollar need not be paid.
An insured or an 
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insured's assignee shall be
notified by the insurer, health 
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maintenance organization, managed care plan,
health care plan, 
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preferred provider organization, or third party administrator

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of any known failure to provide sufficient documentation for a

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due proof of
loss within 30 days after receipt of the claim.

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Any
required interest payments shall be made within 30 days 
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after the payment.

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    The requirements of this Section shall apply to any policy 
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of accident
and health insurance delivered, issued for 
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delivery, renewed or amended on
or after 180 days following the 
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effective date of this amendatory Act of 1985.
The requirements 
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of this Section also shall specifically apply to
any group 
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policy of dental insurance only, delivered, issued for

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delivery, renewed or amended on or after 180 days following the 
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effective
date of this amendatory Act of 1987. The changes to 
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this Section made by this amendatory Act of the 96th General 
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Assembly shall apply to any policy of accident and health 
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insurance delivered, issued for delivery, renewed, or amended 
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on or after 180 days following the effective date of this 
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amendatory Act of the 96th General Assembly. 

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(Source: P.A. 91-605, eff. 12-14-99.)

 



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    (215 ILCS 5/357.9a)  (from Ch. 73, par. 969.9a)



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    Sec. 357.9a. Delay in payment of claims. Periodic payments

 


 






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of accrued indemnities for disablement or for loss-of-time 
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coverage under both individual and group accident
and health 
3
policies, as well as payment of accrued indemnity under any 
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individual or group life or accidental death policy, shall 
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commence not later than 30 days after
the receipt by the 
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company of the required written proofs of loss.
An insurer 
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which violates this Section if liable under said policy, shall

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pay to the insured, in addition to any other penalty provided 
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for in this Code,
interest at the rate of 9% per annum from the 
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30th day after
receipt of such proofs of loss to the date of 
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late payment of the
accrued indemnities, provided that interest 
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amounting to less than
one dollar need not be paid.

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(Source: P.A. 92-139, eff. 7-24-01.)