NJ A5793

Health insurance carriers are prohibited from denying payment on all or a portion of a claim while seeking coordination of benefits information, regardless of whether the carrier has good cause to believe other insurance coverage is available to the covered person

The bill removes the previous exception that allowed payers to deny claims while seeking coordination of benefits information when the payer's records indicated other coverage existed

The prohibition applies to hospital service corporations, medical service corporations, health service corporations, prepaid prescription service organizations, health insurers, and health maintenance organizations

The bill takes effect 90 days after enactment and applies to health insurance plans, contracts, or policies entered into or renewed on or after the effective date

The legislation amends multiple sections of P.L.1999, c.154 and supplements P.L.1997, c.192 to extend protections across various types of health insurance carriers operating in New Jersey