Serio Says N.Y. Court of Appeals to Hear Reg. 68 Case; NYSID Continues Anti-Fraud Fight

February 28, 2003

New York’s Superintendent of Insurance Gregory Serio told a Capital District luncheon crowd this week that his Department has just learned that the New York Court of Appeals has granted leave for plaintiffs to appeal the NYSID’s unanimous victory at the Appellate Division in the challenge to its revisions to Regulation 68 no-fault claims timeframes.

The PIANY reported that Serio was committed to implementing the changes, and that the NYSID would “continue to fight for these changes to be upheld.” He asked the crowd for help in discrediting a legislative attempt (S.177/A.269, opposed by PIANY) to roll back these amendments.

Regulation 68, as originally proposed in 2001, institutes new timeframes for accident victims to report a claim and medical providers to submit claims for payment. It’s aimed at eliminating existing loopholes that the NYSID has indicated “have been exploited as opportunities for fraud and abuse.” It reduces the time medical providers have from each treatment to submit claims for payment from 180 days to 45 days, while it maintains the amount of time the carrier has to pay on claims. Successive court challenges from consumer groups and lawyers associations have delayed the implementation of the rule changes.

The PIANY also reported that Serio reiterated his Department’s commitment to the fight against insurance fraud, and his intention to work for additional anti-fraud tools. He appealed to the Legislature to take action. “We can point to bodies lying in the street to show them this is a problem that is out of control,” he reportedly said, in a reference to a recent Brooklyn shooting that reportedly involved rival insurance fraud operators fighting over turf. “It’s become a law and order issue, and this is not the only example.”

The overall theme of Serio’s remarks was the success of the NYSID in addressing many serious issues before they became crises. “If the Legislature doesn’t do anything about auto insurance fraud, they will be primarily, if not exclusively, responsible for what happens in the auto insurance market,” he noted. He singled out the Assembly, which has declined to pass legislation outlawing “runners” of the type allegedly involved in the Brooklyn shooting, as well as a package of auto insurance “extenders” including the “two-percent” and “flex-rating” provisions, although the PIANY bulletin indicated that the. The Assembly did pass the two- percent extender on a stand-alone basis.

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