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H 1250

An Act relative to greater fairness in insurance

194th Legislature (2025-2026) Introduced by Jay Livingstone

The bill prohibits discretionary authority in insurance policies, requiring form compliance with Massachusetts law to prevent deferential review and protect consumer rights.

Accompanied a study order, see H5336
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Bill Summary · H 1250

Summary of House Bill H.1250: An Act relative to greater fairness in insurance

Executive overview
H.1250 introduces new protections intended to limit insurers’ use of discretionary authority in determining eligibility, interpreting policy terms, or applying claims decisions. The bill prohibits provisions that reserve such discretionary power if they could lead to a deferential standard of review, and it conditions policy approval on compliance with these protections. The measure targets life, health, disability, accident, long-term care, and related insurance products, with application to Massachusetts residents regardless of where the policy is issued.

Key provisions and changes

  • New statutory provision: Chapter 175, added Section 231

    • (a) Prohibition on discretionary language: Any policy or agreement that reserves discretionary authority to the insurer (or its agents) to determine eligibility, interpret terms, or set review standards that conflict with Massachusetts law is void and unenforceable.
    • (b) Renewed defined: A policy is “renewed” if it continues in force on or after its anniversary date.
    • (c) Definition of “discretionary authority”: A provision that grants the insurer power to determine entitlement to benefits or interpret language in a way that could yield a deferential standard of review is deemed discretionary.
    • (d) Permissible disclosures: Insurers may include routine-operational disclosures about decisions, benefit determinations, and claims procedures so long as these disclosures cannot create a deferential standard of review.
    • (e) Commissioner’s approval standards: The Insurance Commissioner may not approve health, life, or disability policies that contain discretionary-authority provisions, inconsistent interpretations, misleading clauses, illegible forms, or any provisions that fail to conform with Massachusetts law.
    • (f) Severability: If any part of Section 231 is found illegal or unenforceable, the remainder remains in effect to the extent possible.

  • Scope of application

    • Applies to policies offered, issued, delivered, or renewed, whether or not in Massachusetts, that cover Massachusetts residents and provide life, health, annuity, accident, long-term care, or disability coverage.

  • Definitions and clarifications

    • “Discretionary authority” emphasizes the potential for a policy to create a deferential standard of review by courts.
    • The bill clarifies that routine operational language is allowed only if it cannot lead to a deferential standard of review.

Who is affected

  • Primary beneficiaries: Massachusetts residents enrolled in or eligible for health, life, disability, long-term care, or accident insurance.
  • Insurers and agents: Subject to new prohibitions on discretionary provisions and to stricter form-approval criteria.
  • Regulator: Massachusetts Commissioner of Insurance gains enhanced authority to review and approve policy forms.

Procedural and timeline aspects

  • Introduction: February 27, 2025
  • House docket: No. 1250
  • Referred to: Committee on Financial Services (2025-02-27)
  • Senate action: Senate concurred on 2025-02-27 (per legislative actions)
  • Hearing: Scheduled for May 13, 2025, from 10:00 AM to 1:00 PM in room A-2
  • Related bill: HD 1710 (the substitute/replacement version)

Potential implications

  • Consumer protection: Reduces insurer leverage from discretionary language that could undermine guaranteed benefits or neutral interpretations.
  • Compliance costs: Insurers may need to revise policy forms, rider language, and disclosures to remove discretionary hooks and ensure MA-law conformity.
  • Regulatory oversight: Increased scrutiny by the Massachusetts Insurance Commissioner over form approvals and consistency with state law.
  • Legal risk: Provisions deemed invalid would be unenforceable; the clause severability helps preserve remaining provisions.

Related information
- The bill is branded as “An Act relative to greater fairness in insurance” and is identified as House No. 1250 in the 2025-2026 session. It is associated with Representative Jay D. Livingstone (8th Suffolk). The related HD 1710 is noted as a replacement version.

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

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