Insurance: no-fault; choice of either an independent medical exam or a utilization review; require. Amends secs. 3151 & 3157a of 1956 PA 218 (MCL 500.3151 & 500.3157a).
Impact
The proposed amendments would strengthen the insurance policies regarding mental and physical examinations, necessitating that examining physicians have specialized qualifications matching those of the treating physicians. Such measures could enforce higher standards of care and accountability within medical examinations associated with insurance claims. Supporters assert that this could potentially reduce fraudulent claims and ensure that claims are substantiated by medical evaluations of adequate quality.
Summary
House Bill 4687 is designed to amend sections 3151 and 3157a of the Michigan insurance code, focusing on the procedures related to personal protection insurance claims. This bill allows for the requirement of either an independent medical examination or a utilization review at the request of an insurer when an individual's mental or physical condition is relevant to a claim. This change aims to enhance the evaluation process of claims and could streamline insurance coverage assessments for individuals seeking personal protection insurance benefits.
Contention
However, there are concerns regarding the impact on claimants, particularly around the potential for increased scrutiny and requirements that might delay access to benefits or care. Critics may argue that the bill places excessive burdens on patients who are already vulnerable or that it could lead to treatment delays, creating barriers to obtaining necessary care. The balance between protecting against fraud and ensuring timely healthcare access could be a significant point of contention as the bill progresses through the legislative process.
Insurance: no-fault; treatment and service for injuries; revise standards and procedures for utilization reviews. Amends sec. 3157a of 1956 PA 218 (MCL 500.3157a).