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2018 Georgia Code 33-24-56 | Car Wreck Lawyer

Link to State of Georgia Official Statute 2018 Georgia Code Annotated (sourced from legal.resource.org)
O.C.G.A. 33-24-56 Case Law from Google Scholar Amendments to OCGA 33-24-56

TITLE 33 INSURANCE

Section 24. Insurance Generally, 33-24-1 through 33-24-98.

ARTICLE 1 GENERAL PROVISIONS

33-24-56. Prohibition against requiring referral from primary care physician to dermatologist.

  1. It is the intent of the General Assembly to encourage health care cost containment while preserving the quality of care offered to citizens of this state. The General Assembly finds that there is an increasing number of health insurance benefit providers which require a referral from a primary care physician to a dermatologist as a condition of the payment of benefits to an insured patient. The General Assembly finds that such a requirement as it relates to dermatological services may block unfairly a patient's choice of direct access to providers of health care services and may not be in the public interest.
  2. As used in this Code section, the term:
    1. "Dermatological services" means services ordinarily and customarily rendered by a physician specializing in the practice of dermatology.
    2. "Health benefit policy" means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, or renewed in this state by a health care corporation, health maintenance organization, accident and sickness insurer, fraternal benefit society, or similar entity.
  3. No health benefit policy which is issued, delivered, issued for delivery, or renewed in this state on or after July 1, 1995, shall require as a condition to the coverage of dermatological services that an enrollee, subscriber, or insured first obtain a referral from a primary care physician, as such term is defined by the group plan, policy, or contract for health care services.

(Code 1981, §33-24-56, enacted by Ga. L. 1995, p. 235, § 1; Ga. L. 2017, p. 164, § 28/HB 127.)

The 2017 amendment, effective July 1, 2017, deleted "nonprofit hospital service corporation, nonprofit medical service corporation," preceding "or similar entity" near the end of paragraph (b)(2).

Law reviews.

- For annual survey article discussing developments in insurance law, see 51 Mercer L. Rev. 313 (1999).

Cases Citing O.C.G.A. § 33-24-56

Total Results: 4  |  Sort by: Relevance  |  Newest First

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Woodcraft ex rel. MacDonald, Inc. v. Georgia Cas. & Sur. Co., 293 Ga. 9 (Ga. 2013).

Cited 34 times | Published | Supreme Court of Georgia | May 20, 2013 | 743 S.E.2d 373

...See, e.g., Duncan v. Integon Gen. Ins. Corp., 267 Ga. 646, 647 (482 SE2d 325) (1997) (“made whole” doctrine required that insured be completely compensated for his losses before his insurer could exercise right of reimbursement for medical benefits paid); OCGA § 33-24-56.1 (c) (With respect to “the settlement of any claim for personal injury [between the insured and tortfeasor]......
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Thurman v. State Farm Mut. Auto. Ins., 598 S.E.2d 448 (Ga. 2004).

Cited 20 times | Published | Supreme Court of Georgia | Jun 7, 2004 | 278 Ga. 162, 2004 Fulton County D. Rep. 1880

...blic policy strongly supportive of the complete compensation rule: an insurer is prohibited from obtaining reimbursement for amounts paid under medical payments coverage unless and until the insured has been completely compensated for her loss. OCGA § 33-24-56.1(b); Davis v. Kaiser Foundation etc., 271 Ga. 508, 521 S.E.2d 815 (1999). See also Duncan v. Integon Gen. Ins. Corp., 267 Ga. 646, 482 S.E.2d 325 (1997). The complete compensation rule set forth in OCGA § 33-24-56.1(b) echoes the statutory limitation placed on the 1992 reinstatement of the subrogation lien in workers' compensation cases — the recovery of the employer or its *451 insurer pursuant to that lien is conditioned upon the injured employee having been "fully and completely compensated ......
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Davis v. Kaiser Found. Health Plan of Georgia, Inc., 521 S.E.2d 815 (Ga. 1999).

Cited 14 times | Published | Supreme Court of Georgia | Oct 12, 1999 | 271 Ga. 508, 99 Fulton County D. Rep. 3717

...d subsequent to the effective date of the policy at issue, and in part on the dissent in Duncan, supra. Key to the Court of Appeals's reasoning that there was no public policy which would void the reimbursement provision was its construction of OCGA § 33-24-56.1, which permits the sort of reimbursement involved here only when the insured has been completely compensated for the loss for which benefits were paid....
...f the section imperatively demands a different construction. [Cits.]" Sinclair v. Friedlander, 197 Ga. 797, 798-799, 30 S.E.2d 398 (1944). Application of that principle would require the conclusion that the legislature intended, when it enacted OCGA § 33-24-56.1, to state the pre-existing law, that the rule of complete compensation is the public policy of this State. Having found no expression of a pre-existing public policy of complete compensation in OCGA § 33-24-56.1, the Court of Appeals proceeded with its analysis and chose to adopt the rationale of the dissent in Duncan. However, the dissent in Duncan was written without the benefit of the legislature's enactment of OCGA § 33-24-56.1, which established that the complete compensation rule was the existing law of this State....
...With the benefit of that legislation and the application of the proper principle of statutory construction, we conclude that the General Assembly was alerted by the decision in Duncan to the absence of a clear statement of existing law on the question, and enacted OCGA § 33-24-56.1 *818 to make unmistakable that complete compensation is the public policy of this State....
...rcise of that power. There may have been, when Duncan was decided in 1997, a legitimate question concerning the strength and extent of the public policy of complete compensation, but that question was put to rest by the legislature's passage of OCGA § 33-24-56.1....
...is a risk the insured has paid it to assume." [Cit.] (emphasis in original) Id. at 777. We find the reasoning of the Alabama Supreme Court in Powell compelling and adopt it. Combined with our conclusion that the General Assembly's enactment of OCGA § 33-24-56.1 confirms the complete compensation rule as the public policy of this State, that rationale requires us to hold that the insurance policy provision involved in this case is unenforceable as violative of public policy because it required reimbursement without regard to whether the insured was completely compensated....
...All the Justices concur, except FLETCHER, P.J., who concurs in the judgment only. HINES, Justice, concurring. Although I agreed with the dissent in Duncan v. Integon Gen. Ins. Corp., 267 Ga. 646, 482 S.E.2d 325 (1997), I join in the opinion in this case because of the legislature's enactment of OCGA § 33-24-56.1....
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Anderson v. Mullinax, 497 S.E.2d 796 (Ga. 1998).

Cited 9 times | Published | Supreme Court of Georgia | Apr 13, 1998 | 269 Ga. 369

...787, 791, 471 S.E.2d 500 (1996). [4] Johnson v. State Farm, 216 Ga.App. 541, 544, 455 S.E.2d 91 (1995) [5] See Johnson, 216 Ga.App. at 544, 455 S.E.2d 91 (clause allowing set-off is not against public policy where total damages do not exceed policy limits); see also O.C.G.A. § 33-24-56.1 (subrogation and claims for reimbursement by insurers allowed where insured first recovers total damages)....