Mich. Comp. Laws § 500.3406k. Emergency health services; medically necessary coverage; “stabilization“ defined: Disability Insurance Policies – Michigan

Status: Enacted
Year Enacted: 1998
Year Amended: 2016
File: Download

An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that provides coverage for emergency health services shall provide coverage for medically necessary services provided to an insured for the sudden onset of a medical condition that manifests itself by signs and symptoms of sufficient severity, including severe pain, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in serious jeopardy to the individual’s health or to a pregnancy in the case of a pregnant woman, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

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