CHAPTER 16. INSURANCE CLAIM FORM NOTICE
IC 27-2-16
Chapter 16. Insurance Claim Form Notice
IC 27-2-16-1
Supplemental construction of chapter
Sec. 1. This chapter is supplemental to IC 27-1.
As added by P.L.193-1991, SEC.1.
IC 27-2-16-2
"Insurer" defined
Sec. 2. As used in this chapter, "insurer" has the meaning set forth
in IC 27-1-2-3(x).
As added by P.L.193-1991, SEC.1.
IC 27-2-16-3
Claim forms; statement of false claim constituting fraud; effect of
absence of statement
Sec. 3. (a) All preprinted claim forms provided by an insurer to a
claimant that are required as a condition of payment of a claim must
contain a statement that clearly states in substance the following:
"A person who knowingly and with intent to defraud an insurer
files a statement of claim containing any false, incomplete, or
misleading information commits a felony.".
(b) The lack of a statement required under subsection (a) does not
constitute a defense against a prosecution under IC 35-43-5-4.5.
As added by P.L.193-1991, SEC.1. Amended by P.L.181-2005,
SEC.1.
IC 27-2-16-4
Identification cards and benefit booklets; utilization review
determination clause
Sec. 4. An insurer shall include on each identification card and on
all benefit booklets that are delivered to an enrollee (as defined in
IC 27-8-17-3) whose policy requires a utilization review
determination (as defined in IC 27-8-17-8) a printed statement in
boldface 8 point type in the benefit booklets and in 6 point type on
the identification cards that reads substantially as follows:
"NOTICE: Precertification or preauthorization does NOT
guarantee coverage for or the payment of the service or
procedure reviewed.".
As added by P.L.132-1994, SEC.1.