(a)(1) A health carrier shall pay a penalty of twelve percent (12%) per annum for late payment of claims under a health insurance contract pursuant to rules promulgated by the Insurance Commissioner, without necessity for demand for payment by a claimant.(2) Hiring a third-party administrator or other person to process claims shall not relieve a health carrier of its obligation to pay this penalty.(b) For purposes of this section: (1) 'Claimant' means a person insured or covered by a health carrier, a provider holding a valid assignment from a person insured or covered by a health carrier, or a provider contracted with a health carrier, who is claiming a benefit under a health insurance contract;(2)(A) 'Health carrier' means a health maintenance organization, hospital medical service corporation, or a disability insurance company.(B) 'Health carrier' includes a self-insured governmental or church plan and third-party administrators that administer or adjust disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan.(C) 'Health carrier' does not include: (i) An a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan.(C) 'Health carrier' does not include: (i) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or(ii) Any person, company, or organization licensed or registered to issue or who issues any insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 - 23-62-107 providing medical or hospital benefits for accidental injury or disability; and(3)(A) 'Health insurance contract' means a disability insurance policy, a hospital medical service corporation contract, a health maintenance organization contract, or a plan document issued or provided by a health carrier.(B) 'Health insurance contract' does not include a disability income insurance policy, a long-term care contract, a hospital indemnity contract, an accident-only contract, or any other form of disability insurance policy that provides a benefit as a result of a sickness or accident that does not directly cover expenses related to healthcare treatment.Amended by Act ct, or any other form of disability insurance policy that provides a benefit as a result of a sickness or accident that does not directly cover expenses related to healthcare treatment.Amended by Act 2019, No. 315,§ 2664, eff. 7/24/2019.Acts 2001, No. 1454, § 1.
Arkansas Legal Code