HOUSE BILL No. 4539

 

April 8, 2003, Introduced by Reps. Condino, Lipsey, Vagnozzi, Stallworth, Sak, Hunter, Bieda, Hood, Gieleghem, Phillips, Smith, Wojno, Minore, Woodward, Dennis, O'Neil, Meisner, Tobocman, Hopgood, Paletko, Anderson, Gleason, Accavitti, Farrah, Law, Plakas, Kolb, Cheeks, Jamnick, Brown, Whitmer, Murphy and Daniels and referred to the Committee on Insurance.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1956 PA 218, entitled                                             

                                                                                

    "The insurance code of 1956,"                                               

                                                                                

    by amending section 4507 (MCL 500.4507), as added by 1995 PA 276,           

                                                                                

    and by adding section 2006a; and to repeal acts and parts of                

                                                                                

    acts.                                                                       

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 2006a.  (1) An insurer that falsely accuses an insured                 

                                                                                

2   of arson or a fraudulent insurance act engages in an unfair or              

                                                                                

3   deceptive act or practice in the business of insurance.                     

                                                                                

4       (2) An insurer that knowingly offers an amount less than a                  

                                                                                

5   reasonable person would believe the insured is entitled to                  

                                                                                

6   receive to resolve a claim engages in an unfair or deceptive act            

                                                                                

7   or practice in the business of insurance.  This conduct may be              

                                                                                

8   determined by a court to constitute bad faith by the insurer.               

                                                                                

9       (3) If an insurer engages in conduct described in subsection                

                                                                                


                                                                                

1   (1) or (2), all of the following apply:                                     

                                                                                

2       (a) The insured may bring an action against the insurer and                 

                                                                                

3   may recover all of the following:                                           

                                                                                

4                                                                                (i) Actual damages, including economic and noneconomic                              

                                                                                

5   damages.                                                                    

                                                                                

6       (ii) Punitive and exemplary damages.                                         

                                                                                

7       (iii) Actual attorney fees and costs.                                        

                                                                                

8       (b) The commissioner may suspend, limit, or revoke the                      

                                                                                

9   insurer's authority.                                                        

                                                                                

10      (c) The commissioner or the attorney general may bring an                   

                                                                                

11  action on behalf of 1 or more insureds to enforce the rights of             

                                                                                

12  the insureds under this section.                                            

                                                                                

13      (4) As used in this section:                                                

                                                                                

14      (a) "Economic damages" means medical expenses, the cost of                  

                                                                                

15  rehabilitation services and custodial care, loss of wages, loss             

                                                                                

16  of future earnings, loss of use of property, cost of repair or              

                                                                                

17  replacement of property, loss of employment, or other pecuniary             

                                                                                

18  damages.                                                                    

                                                                                

19      (b) "Fraudulent insurance act" means conduct described in                   

                                                                                

20  section 4503.                                                               

                                                                                

21      (c) "Noneconomic damages" means pain, suffering,                            

                                                                                

22  inconvenience, physical impairment, disfigurement, mental                   

                                                                                

23  anguish, emotional distress, loss of society and companionship,             

                                                                                

24  loss of consortium, injury to reputation, humiliation, or other             

                                                                                

25  nonpecuniary damages.                                                       

                                                                                

26      Sec. 4507.  (1) Upon written request by an authorized agency                

                                                                                

27  to an insurer, the insurer or an agent authorized by the insurer            


                                                                                

1   to act on its behalf may release to the authorized agency, at the           

                                                                                

2   authorized agency's expense,  any or  all information that is               

                                                                                

3   considered important relating to  any  suspected insurance                  

                                                                                

4   fraud.  An authorized agency may release information on suspected           

                                                                                

5   insurance fraud to an insurer or an agent authorized by an                  

                                                                                

6   insurer to act on its behalf upon a showing of good cause by the            

                                                                                

7   insurer or the insurer's authorized agent.  This information may            

                                                                                

8   include, but is not limited to, the following:                              

                                                                                

9       (a) Insurance policy information relevant to an                             

                                                                                

10  investigation, including  any  an application for a policy.                 

                                                                                

11      (b) Policy premium payment records that are available.                      

                                                                                

12      (c) History of previous claims made by the insured.                         

                                                                                

13      (d) Information relating to the investigation of the                        

                                                                                

14  suspected insurance fraud, including statements of any person,              

                                                                                

15  proofs of loss, and notice of loss.                                         

                                                                                

16      (2) If an insurer knows or reasonably believes it knows the                 

                                                                                

17  identity of a person who it has reason to believe committed a               

                                                                                

18  fraudulent insurance act or has knowledge of a suspected                    

                                                                                

19  fraudulent insurance act that is reasonably believed not to have            

                                                                                

20  been reported to an authorized agency, then for the purpose of              

                                                                                

21  notification and investigation, the insurer or an agent                     

                                                                                

22  authorized by an insurer to act on its behalf may notify an                 

                                                                                

23  authorized agency of the knowledge or belief and provide any                

                                                                                

24  additional information in accordance with subsection (1).                   

                                                                                

25      (3) An insurer providing information to an authorized agency                

                                                                                

26  pursuant to subsection (2) has the right to request in writing              

                                                                                

27  information in the possession or control of the authorized agency           


                                                                                

1   relating to the same suspected fraudulent insurance act of which            

                                                                                

2   the insurer notifies the authorized agency under subsection (2).            

                                                                                

3   Upon a showing of good cause by the insurer, the authorized                 

                                                                                

4   agency may provide the requested information at the insurer's               

                                                                                

5   expense within 30 days of the request.                                      

                                                                                

6       (4) In addition to providing information to an insurer under                

                                                                                

7   subsection (3), the authorized agency provided with information             

                                                                                

8   pursuant to subsection (1) or (2) may release or provide the                

                                                                                

9   information to any other authorized agency.                                 

                                                                                

10      (5) Nothing in this chapter impairs a person's right, as of                 

                                                                                

11  the effective date of this chapter  March 28, 1996, to submit to           

                                                                                

12  the insurer or the insurer's representative a statement fully               

                                                                                

13  explaining the basis of the claim and to have that statement                

                                                                                

14  placed in the claim file.                                                   

                                                                                

15      (6) An authorized agency, insurer, or an agent authorized by                

                                                                                

16  an insurer to act on its behalf shall not request or release                

                                                                                

17  information under subsection (1) for any purpose other than for             

                                                                                

18  the investigation of suspected insurance fraud.                             

                                                                                

19      (7) An insurer shall remove all documents relating to                       

                                                                                

20  allegations of fraudulent insurance acts that have been                     

                                                                                

21  determined to be unfounded from the claim file of a person who              

                                                                                

22  makes a request for removal.                                                

                                                                                

23      Enacting section 1.  Section 4509 of the insurance code of                  

                                                                                

24  1956, 1956 PA 218, MCL 500.4509, is repealed.