Relates to insurance losses as a result of the insured being intoxicated or under the influence of narcotics

Section 2 of the bill would provide that the bill will take effect 180 days after enactment and will apply to all policies issued, renewed, modified, altered or amended on or after such date.

Existing law

Under current law, a no-fault insurer may exclude a person from no-fault insurance coverage if the per$on sustains injuries as a result of operating a motor vehicle while intoxicated or drug-impaired.

Prior legislative history

In 2008, A.10000/S.8294-A, amending Insurance Law § 5103(b)(2) passed both houses but was vetoed by the Governor (Veto Message No. 170). Governor Paterson explained that, while the goals of the bill were sound, it was drafted so expansively that it would have required coverage far in excess of emergency care. The Governor's veto message instructed his staff and interested parties to "help enact a new bill that accomplishes the intended purpose...in a manner that will protect the interests of the health service providers, injured patients and the public."

Statement in support

Under the Public Health Law and the federal Emergency Medical Treatment and Active Labor Act, health services providers are required to provide emergency medical services to persons in need of such care. The Insurance Law, however, permits no-fault insurers to deny coverage where the insured person is injured while operating a vehicle in an intoxicated state. As a result, health services providers are sometimes not compensated for services they are required to render to stabilize their patients in emergency situations. This is both inequitable to doctors and, by leading doctors to avoid blood alcohol and other tests for intoxication or drug use for fear they will lead to denial of compensation, undermines medically appropriate screening procedures.

In 2008, a bill was introduced to address this situation (A.10000/S.8294-A), but it was vetoed by Governor Paterson because it was not limited to emergency care, but rather would have required no-fault carriers to have reimbursed providers for virtually all health services given to intoxicated individuals. The Governor's veto message expressed support for the bill's stated goal, and urged that a new bill be drafted and enacted to effectuate this purpose.

In response, OASAS and the New York State Insurance Department have drafted a bill that provides for a narrow amendment to Insurance Law § 5103(b)(2). This amendment would prohibit a no-fault insurer from excluding from coverage a person who sustains injuries as a result of operating a motor vehicle while intoxicated, with respect to necessary emergency health services rendered in a general hospital, as defined in Public Health Law § 2801(10), including ambulance services attendant thereto and related medical screening. This amendment is intended to permit a health service provider to obtain reimbursement for any necessary emergency services performed in a general hospital or by an ambulance worker outside of a general hospital, on a person who has sustained injuries as a result of operating a motor vehicle while intoxicated or drug impaired. This bill also would permit reimbursement for necessary related medical screening, such as blood alcohol and drug tests, performed in a general hospital or by an ambulance worker outside of a general hospital.

By permitting reimbursement for necessary related medical screenings, such as blood alcohol and drug tests, more screenings will occur, underlying drug or alcohol problems will be more frequently identified and addressed, and ultimately fewer drug or alcohol-related injuries will occur.

Budget implications

This proposal has no significant fiscal impacts.

Effective date

This bill would take effect 180 days after enactment and would apply to all policies issued, renewed, modified, altered or amended on or after such date.