AB 1189

This bill provides that an insurer may retroactively deny reimbursement for a claim under a health insurance policy only during the 12-month period following the date that the insurer initially provided reimbursement for the claim. If the claim was subject to coordination of benefits with another third-party payer, the bill instead provides that an insurer may retroactively deny reimbursement for a claim under a health insurance policy only during the 18-month period following the date that the insurer initially provided reimbursement for the claim. The limitations described under the bill do not apply to any retroactive denial of reimbursement if an insurer retroactively denied reimbursement for the claim because the information submitted to the insurer to support the claim was fraudulent. Health insurance policies are referred to as disability insurance policies in the bill and under current law.