Insurance Legislation Helps Protect Wyoming Consumers’ Rights

Health insurance holders will soon have more recourse against insurance companies that deny claims, thanks to two bills passed by the Wyoming Legislature.

Senate res 62 banned so-called discretionary clauses, which allow insurance companies to deny claims for any medical procedure—even those procedures explicitly covered in policies. And Senate res 95 established a review procedure for consumers seeking to contest denied claims.

Sen. Tony Ross, R-Cheyenne, who sponsored both bills, said the new laws give policyholders more recourse against insurance companies who deny claims.

Beginning July 1, insurance companies will not be able to include discretionary clauses in new contracts, nor exercise them in existing ones. And policy holders with denied claims will be able to appeal the decision to an independent review board starting July 1, 2010.

Ross said community involvement and testimony from those who had been affected by the old insurance code helped secure the passage of the legislation.

“It was clearly evident that there is a problem that needed to be addressed,” Ross said.

AARP Wyoming and the Coalition for Wyoming Insurance Solutions in Healthcare, composed of national and state organizations, pushed for the passage of the legislation. Jan Drury, government affairs director for the American Heart Association/American Stroke Association, a coalition leader, said the bills fit into the coalition’s goal to make health care easier to access and more affordable for all.

“After doing some research we decided these were specific consumer protections that would help people get their money’s worth out of insurance policies,” Drury said.

Ross said he has already heard from individuals whose insurance companies paid for treatment and admission into a clinical trial because of the new laws, even though they haven’t yet gone into effect.

“It’s pretty neat to see some real-life consequence of the legislation we passed,” Ross said.

Other Resources

Read the bill prohibiting insurance policy discretionary clauses in Wyoming

Read the bill that established an insurance appeal process in Wyoming

Wyoming Department of Insurance’s Consumer Assistance program