By Assemblyman Will Barclay
One of my focuses as a lawmaker has been to improve insurance-related laws in New York. I’m currently the Ranking Minority Member on the Assembly Insurance Committee. There are a number of bills I’d like to see pass that would improve the atmosphere in the insurance industry, crack down on insurance fraud and, ultimately, lower premiums in New York.
No-fault automobile insurance is aimed to get consumers help paying medical claims quickly, reduce litigation, and keep premiums down.
There are flaws in this system, however, and criminals have found loopholes. According to statistics, New Yorkers pay the third highest premiums in the nation. Insurance fraud is one reason why our premiums are high in this state. In recent years, insurance companies reported that fraud has increased and incidents of people staging accidents, recruiting injured drivers, and some doctors have also been involved with dishonest practice to try and get money from insurance companies.
In February, the U.S. Attorney for the Southern District of New York announced the indictment of 36 people for participating in a $279 million no-fault fraud scheme. In March, the state recognized no-fault insurance fraud and instituted regulatory reforms.
These reforms included ending requirements that mandate insurers pay for treatments that were never actually provided or pay more than the established fee schedule for a given service. The reforms also addressed healthcare providers ignoring requests for evidence that the treatments are medically necessary. Healthcare providers are now required to provide a response within 120 days.
The state also identified 135 doctors that have previously submitted questionable claims in March.
These reforms are a good start but legislative changes are necessary.
I’m re-introducing legislation in our upcoming session that would compensate people who report insurance fraud to the authorities.
We also need to increases penalties for insurance fraud. Legislation I sponsor would make billing for fraudulent claims more difficult by establishing treatment guidelines.
This would help bring down the average no-fault personal injury protection claim, which is the third highest in the nation. Currently, no-fault personal injury claims’ average costs are $9,007.
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My office can be reached by mail at 200 North S. Street, Fulton, NY 13069, by e-mail at [email protected] or by calling (315) 598-5185.
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