§431:10C-212  Administrative hearing on
insurer's denial of claim.  (a)  If a claimant or provider of services
objects to the denial of benefits by an insurer or self-insurer pursuant to
section 431:10C-304(3)(B) and desires an administrative hearing thereupon, the
claimant or provider of services shall file with the commissioner, within sixty
days after the date of denial of the claim, the following:



(1)  Two copies of the denial;



(2)  A written request for review; and



(3)  A written statement setting forth specific
reasons for the objections.



(b)  The commissioner has jurisdiction to
review any denial of personal injury protection benefits.



(c)  The commissioner shall:



(1)  Conduct a hearing in conformity with chapter 91
to review the denial of benefits;



(2)  Have all the powers to conduct a hearing as set
forth in section 92-16; and



(3)  Affirm the denial or reject the denial and order
the payment of benefits as the facts may warrant, after granting an opportunity
for hearing to the insurer and claimant.



(d)  The commissioner may assess the cost of
the hearing upon either or both of the parties.



(e)  Either party may appeal the final order of
the commissioner in the manner provided for by chapter 91. [L 1987, c 347, pt
of §2; am L 1992, c 124, §7; am L 1997, c 251, §35]



 



Case Notes



 



  The first party to choose a forum for resolution of no-fault
dispute binds the other party to that forum unless the circuit court finds that
the parties have entered into a mandatory and binding arbitration agreement. 
86 H. 59, 947 P.2d 371.



  1992 amendment to subsection (a) applies to claims arising
from injuries sustained in accidents occurring before January 1, 1993; thus,
provider had standing to contest insurer's denial of no-fault insurance
benefits.  90 H. 1, 975 P.2d 211.