(1) An enrollee who is the subject of a decision of an independent review organization has a private right of action against the insurer for damages arising from an adverse decision by the insurer that is subject to external review if:
(a) The insurer states in the health benefit plan in which the enrollee is enrolled that the insurer is not bound by the decisions of an independent review organization; and
(b) The insurer fails to comply with the decision.
(2) The Legislative Assembly intends that there is no private right of action under subsection (1) of this section if a court finds either subsection (1)(a) or (b) of this section to be unconstitutional or otherwise void. [2001 c.266 §14]Section: Previous 743.857 743.858 743.859 743.860 743.861 743.862 743.863 743.864 743.865 743.866 743.868 743.870 743.871 743.874 743.875 Next
Last modified: August 7, 2008