SPRINGFIELD – To increase transparency in health care plans and enhance consumer protections, State Senator Laura Fine advanced legislation that would clarify when an individual is able to challenge an insurance company’s decision to deny a claim.

“Those seeking necessary medical treatments, including those who already received a service, may be surprised when their health insurance refuses to pay for it,” said Fine (D-Glenview). “Current standards for reviewing health care services and procedures may inaccurately and unfairly penalize patients, which can delay access to essential services.”

Health insurance providers may deny coverage or refuse to pay for a service, which is known as an adverse benefit determination. However, consumers are able to request an external review of this denial to evaluate its appropriateness. House Bill 2472 would clarify when a consumer can appeal a denial of benefits or request an external review.

“This legislation outlines a path to ensure consumers have access to affordable healthcare,” said Fine.

House Bill 2472 passed the Senate on Wednesday and heads to the Governor’s desk.