WeVote
Log In

Bill

Bill

HB 7113

AN ACT RELATING TO INSURANCE -- UNFAIR CLAIMS SETTLEMENT PRACTICES ACT

2026 Regular Session Introduced by Joseph McNamara

The bill prohibits insurers from blocking direction-to-pay payments to dental service providers and requires fair, transparent handling of dental claims without reducing benefits.

04/14/2026 Withdrawn at sponsor's request
0
WeVote Research Nonpartisan
Bill Summary · HB 7113

Summary of HB 7113 (2026) – Rhode Island: Unfair Claims Settlement Practices Act (Dental direction-to-pay provision)

Purpose and intent

HB 7113 amends Rhode Island’s Unfair Claims Settlement Practices Act to clarify and extend protections against certain insurer practices in the handling of claims. The bill adds specific prohibitions and requirements aimed at ensuring prompt, fair, and transparent claim processing, with a notable focus on dental service payments and “direction to pay” arrangements. The effective date is upon passage.

Key provisions and changes

  • Unfair claims practices defined (Section 27-9.1-4(a))
    The bill enumerates a broad list of practices by insurers that would constitute unfair claims practices when violated (a) and (b). Many items reiterate and reinforce standards already common in such acts, including timely acknowledgment of communications, prompt investigation, fair settlement without undue delay, and clear explanations for denials or compromises.

  • Expanded protections related to dental services and direction-to-pay (new elements 34–36 in (a))

    • It adds a specific prohibition on insurers refusing to honor a direction-to-pay executed by an insured or claimant directing payment for dental services directly to a dental service provider (DSP), provided the DSP meets credentialing criteria and has not been terminated.
    • The insurer may review the DSP’s records to verify that services were received, but may not use that review to modify benefit amounts.
    • Insurers cannot require DSPs to accept payments exclusively by virtual credit card and must offer alternative payment methods without charging fees for access to payment or claims data, or for transmission/processing of payments.
    • The section clarifies that the direction-to-pay mechanism cannot be used to improperly reduce benefits, and it sets expectations around credentialing and provider relationships.

  • Direct payment mechanics and related protections (new elements within 34)

    • Insurers may review records to verify services but cannot alter benefit amounts under a direction-to-pay for dental services.
    • Prohibits licensing or contractual requirements that force DSPs to accept only certain payment methods.

  • Severability of existing auto repair and appraisal provisions (a)(20–27) and other items
    The bill retains and expounds numerous provisions relating to auto body repairs, appraisals, rental-car coverage, total-loss determinations, sublet services, and related due-diligence standards. These include:

    • Timely appraisals, avoidance of duplicate documentation, and explicit timelines for scheduling and completing appraisals.
    • Requirements around payment terminology, coverage designation, and transparent allocation of payments to specific coverages.
    • Rules governing direct repair programs and the rights of insureds to choose repair shops.
    • Standards for total-loss designation and salvage/title notifications.

  • Effect on existing contracts (Section 1(b))
    Provisions state that the act does not interfere with auto body repair facility contracts or direct repair programs, and it preserves insureds’ right to select their repair shop without reducing compensation.

who is affected

  • Insurers: All insurers operating in Rhode Island, including dental insurers, auto insurers, and health/dental benefit providers, would be subject to these rules and potential penalties for unfair practices.
  • Dental service providers and insureds/claimants: Individuals and DSPs who rely on direct payment directions and those seeking dental-benefit payments directly to providers would gain clarified rights and protections.
  • Public adjusters and mortgagees: Specific rules apply to direction-to-pay arrangements involving public adjusters and to payments where a mortgagee or loss payee is involved.

Procedural and timeline aspects

  • Effective date: The act takes effect upon passage.
  • Legislative history: Introduced January 15, 2026; referred to House Corporations; committee recommendations indicate the measure was held for further study and then withdrawn at sponsor’s request (as of the latest action).
  • The explanatory text notes that the primary new dental-related protections are the core change.

Overall impact

HB 7113 strengthens Rhode Island’s framework to curb unfair claims practices, with targeted enhancements to dental payment directions and broader protections for claimants navigating settlements and repairs. It emphasizes transparency, prompt handling, and equitable settlement while preserving existing contractual relationships between insurers and service providers.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.