February 6, 1978
Circular Letter NO. 4
To: ALL ACCIDENT AND HEALTH INSURERS, EXCLUDING ARTICLE IX-C CORPORATIONS, LICENSED IN NEW YORK STATE
RE: STANDARD CLAIM FORMS FOR ACCIDENT AND HEALTH INSURANCE
Chapter 545 of the Laws of 1977 provides that on or before January 1, 1979, the Superintendent of Insurance shall establish standard claim forms for the services of hospitals, physicians and other health providers to be used for all accident and health insurance claims filed with commercial health insurers. Prior to the establishment of the standard claim forms, the Superintendent, according to Chapter 545 of the Laws of 1977, is to investigate and review claim forms currently utilized by insurance carriers and providers of medical services.
As part of the Superintendent's investigation of currently utilized claim forms, it is requested that you forward copies of one hospital, one medical and one dental claim form now in use by your company which you consider to be the most widely accepted and efficient forms.
In addition to sending the claim forms mentioned above, your comments and suggestions concerning the implementation of Chapter 545 of the Laws of 1977 would be appreciated. Your claim forms and comments should be sent, no later than March 1, 1978, to:
James W. Clyne
NYS Insurance Department
Agency Building One
Empire State Plaza
Albany, New York 12223
Very truly yours,
ALBERT B. LEWIS
Superintendent of Insurance