(a)        Except as provided in N.C. Gen. Stat. § 90-21.52(b), an insured or enrollee who has been found to have been harmed by the managed care entity pursuant to an action brought under this Article may recover actual or nominal damages and, subject to the provisions and limitations of Chapter 1D of the N.C. Gen. Stat., punitive damages.

(b)        This Article does not limit a plaintiff from pursuing any other remedy existing under the law or seeking any other relief that may be available outside of the cause of action and relief provided under this Article.

(c)        The rights conferred under this Article as well as any rights conferred by the Constitution of North Carolina or the Constitution of the United States may not be waived, deferred, or lost pursuant to any contract between the insured or enrollee and the managed care entity that relates to a dispute involving a health care decision. Arbitration or mediation may be used to settle the controversy if, after the controversy arises, the insured or enrollee, or the estate of the insured or enrollee, voluntarily and knowingly consents in writing to use arbitration or mediation to settle the controversy. (2001-446, s. 4.7.)

Terms Used In North Carolina General Statutes 90-21.56

  • Contract: A legal written agreement that becomes binding when signed.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Health care decision: means a determination that is made by a managed care entity and is subject to external review under Part 4 of Article 50 of Chapter 58 of the N. See North Carolina General Statutes 90-21.50
  • in writing: may be construed to include printing, engraving, lithographing, and any other mode of representing words and letters: Provided, that in all cases where a written signature is required by law, the same shall be in a proper handwriting, or in a proper mark. See North Carolina General Statutes 12-3
  • Insured or enrollee: means a person that is insured by or enrolled in a health benefit plan under a policy, plan, certificate, or contract issued or delivered in this State by an insurer. See North Carolina General Statutes 90-21.50
  • Managed care entity: means an insurer that:

    a. See North Carolina General Statutes 90-21.50

  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • United States: shall be construed to include the said district and territories and all dependencies. See North Carolina General Statutes 12-3