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Autism Health Insurance Reform: Action Alert – Ask Legislators to Support HB2858

ACTION: ask the House Business and Labor Committee to support HB2858

On Wednesday 3/15/2017, the House Business and Labor Committee will hold a hearing on HB2858.

As I wrote last week, HB2858 would establish a transparent and efficient process for the Insurance Commissioner to use in helping consumers enforce their rights under the insurance code.

Oregon law currently requires the Insurance Commissioner to record consumer complaints about insurers, and to enforce the insurance code – but there are no laws or administrative rules governing this process. The Insurance Commissioner’s “consumer advocacy unit” can be very helpful in persuading insurers to comply voluntarily, but actual enforcement is extremely rare – less than 0.1% of all consumer complaints result in enforcement (fewer than 4 enforcement actions per year on average).

While the Insurance Commissioner’s announcement earlier this month of enforcement against several insurers for violations related to autism was very welcome news, dozens of similar consumer complaints have been lingering without resolution for many years.

Four years ago, we wrote and passed SB414, which gave the Insurance Commissioner to seek restitution on behalf of consumers. In all this time, it has been used only once, and there are no procedures for consumers to participate in the restitution process for their own case.

HB2858 would enable consumers to do what the Legislature has consistently urged – work through the Insurance Commissioner for enforcement of our rights under the Insurance Code. It would establish a specific process to follow in response to a Consumer Complaint, based on the process that the Civil Rights Division uses to act on Civil Rights complaints. The Insurance Commissioner would be encouraged to involve the consumer in settlement discussions and to seek consumer input on restitution. In the event that a consumer attempted to use the enforcement process but wasn’t able to get a resolution within a year, then the consumer would gain a private right of action to sue on their own for violation of the Insurance Code (instead of just breach of contract).

Please join me in asking the House Business and Labor Committee to pass this important bill to ensure that we our health insurers deliver the benefits that we’ve paid for.

 

————–

Sincerely,

 

Paul Terdal

 

Sample message in support of HB2858 – Enforcement of the Insurance Code

Here’s a short, simple e-mail message that you can use to get started. Revise the last paragraph to describe how this affects you, your family, or your patients, and update the greeting and address.

To:

Members of the House Business and Labor committee:

Rep.PaulHolvey@oregonlegislature.gov

rep.gregbarreto@state.or.us

Rep.JanelleBynum@oregonlegislature.gov

Rep.MargaretDoherty@state.or.us

rep.paulevans@state.or.us

Rep.JulieFahey@oregonlegislature.gov

rep.jodihack@state.or.us

rep.dallasheard@state.or.us

Rep.BillKennemer@state.or.us

CC:

paul@AutismInsuranceOR.org

 

Subject:

Please Support HB2858 – Enforcement of the Insurance Code

Body:

Dear members of the House Business and Labor Committee,

I’m writing in support of HB2858 on remedies for violations of the Insurance Code.

HB2858 establishes transparent and efficient procedures for the Insurance Commissioner to use in adjudicating consumer requests for restitution or enforcement of the insurance code, based on the BOLI Civil Rights Division’s process for adjudicating civil rights complaints. Consumers who are unsuccessful in resolving their complaints through the Insurance Commissioner within a year would gain a private right of action.

While the Insurance Commissioner’s consumer advocacy unit can be very helpful, consumers are often left in the lurch when insurers don’t agree to fix issues voluntarily – there are no laws or administrative rules governing the complaints and enforcement process. The Commissioner’s restitution authority under 2013’s SB414 has been used only once in all the years it has been in effect.

Please support this bill to give insurance consumers an effective process to resolve their issues through the Insurance Commissioner.

 

[*** If you can, please insert a brief personal story here. If you can add a personal story about insurance violations or issues with the Insurance Division’s management of your complaints that would be especially helpful. ***]

 

Thank you,

 

Your Name

123 SW Main

Hometown, OR 97201

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