58-12-24. Refusal of reimbursement due to manner, form, or date of claim prohibited--Time for submission of claim.
Notwithstanding any provision of a policy, plan, contract, or certificate, no insurer may refuse to reimburse the Department of Social Services for medical assistance paid by the department on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale for which reimbursement is sought, if the claim is submitted within three years from the date the item or service was furnished and any action by the department to enforce its rights with respect to such claim is commenced within six years of the department's submission of such claim.
Source: SL 2005, ch 263, §3; SL 2007, ch 286, §2.
Structure South Dakota Codified Laws
Chapter 12 - Insurance Claims And Benefits
Section 58-12-1 - Forms for proof of loss--Furnishing by insurer on request.
Section 58-12-2 - Acts of insurer not constituting waiver of policy provision or defense.
Section 58-12-4 - Life and health insurance--Exemption of benefits and proceeds from execution.
Section 58-12-5 - "Annuity contract" defined.
Section 58-12-8 - Maximum amount of annuity exemption--Excess subject to levy.
Section 58-12-9 - Application of excess annuities to judgment--Factors considered.
Section 58-12-12 - Use of uniform health insurance claim forms.
Section 58-12-13 - Use of claim forms required by federal law excepted.
Section 58-12-14 - Promulgation of rules for uniform health insurance claim forms.
Section 58-12-15 - "Paintless dent repair" defined.
Section 58-12-18 - Compliance with § 58-12-16.
Section 58-12-19 - Clean claim defined.
Section 58-12-25 - Reimbursement to department for cost of services.
Section 58-12-26 - Insurer defined.
Section 58-12-27 - Department defined.
Section 58-12-28 - Provisions of chapter 1-27 not applicable to insurer records.
Section 58-12-31 - Definitions regarding standards for claims processing.
Section 58-12-32 - Application of standards for claims investigation and disposition.
Section 58-12-34 - Acts constituting unfair claims practices.
Section 58-12-35 - Notice of hearing.
Section 58-12-36 - Cease and desist order--Monetary penalty--Suspension or revocation of license.
Section 58-12-37 - Promulgation of rules regarding definitions and records.