The Superintendent of the New York Department of Financial Services, Benjamin Lawsky, has issued an emergency regulation that may make it easier to bar health care providerstemporarily and permanentlywho are suspected of engaging in no-fault insurance fraud from demanding payments from insurance carriers for services they claim to have provided. If the new rule, Insurance Regulation 68-E,1 succeeds in its goal of reducing fraud, it will benefit not only insurance companies operating in New York but also the state’s consumers and all legitimate health care providers.
No-Fault
New York’s no-fault insurance law requires that every vehicle registered in the state have no-fault automobile insurance, enabling the driver and passengers of a registered and insured vehicle to obtain benefits of up to $50,000 per person for injuries sustained in an automobile accident, regardless of fault. The no-fault law requires prompt payment for medical treatment, thereby obviating the need for claimants to file personal injury suits to be reimbursed (although a person who has suffered a “serious injury” as a result of an accident may file a personal injury claim or lawsuit for damages other than no-fault damages).
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