Sec. 3. (a) A:

(1) participating provider; or

Terms Used In Indiana Code 27-13-15-3

  • Attorney: includes a counselor or other person authorized to appear and represent a party in an action or special proceeding. See Indiana Code 1-1-4-5
  • Trustee: A person or institution holding and administering property in trust.
(2) trustee, an agent, a representative, or an assignee of a participating provider;

may not bring or maintain any legal action against a subscriber or an enrollee of a health maintenance organization to collect sums owed by the health maintenance organization.

     (b) Except as provided in subsection (c), if a participating provider of a health maintenance organization brings or maintains a legal action against a subscriber or enrollee for an amount owed to the participating provider by the health maintenance organization, the participating provider is liable to the subscriber or enrollee for costs and attorney‘s fees incurred by the subscriber or enrollee in defending the legal action.

     (c) A participating provider shall not be liable to the subscriber or enrollee for costs and attorney’s fees described in subsection (b) if the participating provider can demonstrate a reasonable basis for believing at the time the legal action was brought and while the legal action was maintained that the health maintenance organization did not owe the sums the participating provider sought to collect from the subscriber or enrollee.

As added by P.L.26-1994, SEC.25. Amended by P.L.203-2001, SEC.26.